Safety and Efficacy of Chest Tube Clamping Versus Non-Clamping Prior to Removal: A Systematic Review and Meta-Analysis Publisher



Kazemloo M ; Rad F N ; Goudarzimehr L ; Shamohammadi M ; Bahrami O ; Heidari A ; Emami M ; Hazaveh M B ; Yarahmadi D
Source: International Journal of Emergency Medicine Published:2026

Abstract

Background: Managing chest tubes before removal remains a controversial clinical issue. Clamping a chest tube before removal is a common practice and is often used to assess latent air leaks. Methods: We systematically searched MEDLINE/PubMed, Embase, Scopus, and Web of Science from inception to 11 February 2026 for studies comparing clamping versus no clamping before chest-tube removal. Two reviewers independently screened and extracted data. Random effect meta-analyses used REML with Hartung-Knapp adjustment, pooling risk ratios for pneumothorax and re-intervention, and mean differences (days) for hospital length of stay. Results: The results of this study show no significant differences between the clamping vs. no-clamping in terms of pneumothorax/hemothorax recurrence, re-intervention rates, or hospital length of stay. Conclusion: Within different causes of applying chest tube/ chest drain, routine clamping before chest-tube removal did not reduce early recurrence or the need for re-intervention. © The Author(s) 2026.