Safety and efficacy of chest tube clamping versus non-clamping prior to removal: a systematic review and meta-analysis.

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.