Table 1

Characteristics of randomized controlled trials comparing the effect of suction with water seal versus water seal alone included in our systematic review and meta-analysis

StudySample sizeEligibility criteriaInterventionOutcomes
Alphonso et al. (13)254

  • Pulmonary surgery

  • Exclusion: lung volume reduction

−20 cm suction v. water seal

  • Prolonged air leak

Ayed (14)100

  • Spontaneous pneumothorax

−20 cm suction v. water seal

  • Prolonged air leak

  • Duration of chest tube

  • Length of hospital stay

Brunelli et al. (15)145

  • Lobectomy with air leak on POD 1

−20 cm suction v. water seal, random assignment of patients on POD 1

  • Prolonged air leak

  • Duration of air leak

  • Length of hospital stay

  • Duration of chest tube

Cerfolio et al. (1)140

  • Pulmonary resection

  • Exclusion: VATS, volume reduction, pneumonectomy

−20 cm suction v. water seal, random assignment of patients on POD 2

  • Prolonged air leak

Daneshvar et al. (16)31

  • Pulmonary resection

  • Exclusion: volume reduction

−10 to −18 cm suction v. water seal, random assignment of patients on POD 1

  • Prolonged air leak

Marshall et al. (2)68

  • Pulmonary resection

  • Exclusion: volume reduction

−20 cm suction v. water seal, random assignment of patients in recovery room

  • Prolonged air leak

  • Duration of air leak

  • Length of hospital stay

  • Duration of chest tube

Prokakis et al. (17)91

  • Lobectomy

  • Exclusion: chemotherapy/radiation

−15 to −20 cm suction v. water seal

  • Prolonged air leak

  • Duration of chest tube

  • Length of hospital stay

  • POD = postoperative day; VATS = video-assisted thoracic surgery.