Impact of alternate active suction on postoperative outcomes after pulmonary lobectomy

Objective. To evaluate efficacy and safety of alternate suction compared to passive drainage after pulmonary lobectomy. Material and methods. A prospective two-center open-label study included 62 patients who underwent lobectomy followed by alternate pleural suction. A retrospective control group comprised 108 patients with passive drainage. To minimize confounding, propensity score matching (1:1) was performed. We distinguished 2 groups of 62 patients each. PAL was defined as air leak for more than 5 postoperative days. Postoperative complications, drainage time, length of hospital stay, and inflammatory indices (NLR, PLR) were analyzed. Results. The incidence of PAL was lower in the active suction group (8.1% vs. 14.5%), although the difference did not reach statistical significance (odds ratio 0.517; 95% confidence interval 0.163–1.640). Severe complications (Clavien-Dindo grade IIIb) were less frequent in the active suction group, and shorter hospital stay was observed (7 [6; 8] days vs. 8 [7; 9] days; p=0.026). By the 5th postoperative day, inflammatory markers were lower in the active suction group. Conclusion. Alternate pleural suction after lobectomy is safe and associated with favorable postoperative course.