scholarly journals Risk factors for prolonged air leak and need for intervention following lung resection

2021 ◽  
Author(s):  
Aaron R Dezube ◽  
Daniel P Dolan ◽  
Emanuele Mazzola ◽  
Suden Kucukak ◽  
Luis E De Leon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Carbon Monoxide ◽  
Length Of Stay ◽  
Wedge Resection ◽  
Lung Resection ◽  
Forced Expiratory Volume ◽  
Air Leak ◽  
Steroid Use ◽  
Diffusion Capacity ◽  
Prolonged Air Leak

Abstract OBJECTIVES Prolonged air leak (PAL; >5 days) following lung resection is associated with postoperative morbidity. We investigated factors associated with PAL and PAL requiring intervention. METHODS Retrospective review of all patients undergoing lobectomy, segmentectomy or wedge resection from 2016 to 2019 at our institution. Bronchoplastic reconstructions and lung-volume reduction surgeries were excluded. Incidence and risk factors for PAL and PAL requiring intervention were evaluated. RESULTS In total, 2384 patients were included. PAL incidence was 5.4% (129/2384); 22.5% (29/129) required intervention. PAL patients were more commonly male (56.6% vs 39.7%), older (mean age 69 vs 65 years) and underwent lobectomy or thoracotomy (all P < 0.001). Patients with PAL had longer length of stay (9 vs 3 days), more discharge needs and increased odds of complication (all P < 0.050). Twenty-nine patients required intervention (9 chest tubes; 4 percutaneous drains; 16 operations). In 50% of operative interventions, an air leak source was identified; however, the median time from intervention to resolution was 13 days. Patients requiring intervention had increased steroid use, lower diffusion capacity for carbon monoxide and twice the length of stay versus PAL patients (all P < 0.050). On univariable analysis, forced expiratory volume in 1 s (FEV1) <40%, diffusion capacity for carbon monoxide <50%, steroid use and albumin <3 had increased odds of intervention (P < 0.050). CONCLUSIONS Age, gender and operative technique were related to PAL development. Patients with worse forced expiratory volume in 1 s or diffusion capacity for carbon monoxide, steroid use or poor nutrition were less likely to heal on their own, indicating a population that could benefit from earlier intervention.

scholarly journals Intraoperative ventilatory leak predicts prolonged air leak after lung resection: A retrospective observational study

PLoS ONE ◽  
2017 ◽  
Vol 12 (11) ◽  
pp. e0187598 ◽  
Author(s):  
Won Ho Kim ◽  
Hyung-Chul Lee ◽  
Ho-Geol Ryu ◽  
Hyun-Kyu Yoon ◽  
Chul-Woo Jung
Keyword(s):  
Observational Study ◽  
Lung Resection ◽  
Retrospective Observational Study ◽  
Air Leak ◽  
Prolonged Air Leak

scholarly journals Comparison of postoperative complications between segmentectomy and lobectomy by video-assisted thoracic surgery: a multicenter study

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Benoît Bédat ◽  
Etienne Abdelnour-Berchtold ◽  
Thomas Perneger ◽  
Marc-Joseph Licker ◽  
Alexandra Stefani ◽  
...  
Keyword(s):  
Risk Factors ◽  
Postoperative Complications ◽  
Thoracic Surgery ◽  
Benign Lesion ◽  
Lung Resection ◽  
Primary Lung Cancer ◽  
Forced Expiratory Volume ◽  
University Hospitals ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted

Abstract Background Compared to lobectomy by video-assisted thoracic surgery (VATS), segmentectomy by VATS has a potential higher risk of postoperative atelectasis and air leakage. We compared postoperative complications between these two procedures, and analyzed their risk factors. Methods We reviewed the records of all patients who underwent anatomical pulmonary resections by VATS from January 2014 to March 2018 in two Swiss university hospitals. All complications were reported. A logistic regression model was used to compare the risks of complications for the two interventions. Adjustment for patient characteristics was performed using a propensity score, and by including risk factors separately. Results Among 690 patients reviewed, the major indication for lung resection was primary lung cancer (86.4%) followed by metastasis resection (5.8%), benign lesion (3.9%), infection (3.2%) and emphysema (0.7%). Postoperatively, there were 80 instances (33.3%) of complications in 240 segmentectomies, and 171 instances (38.0%) of complications in 450 lobectomies (P = 0.73). After adjustment for the patient’s propensity to be treated by segmentectomy rather than lobectomy, the risks of a complication remained comparable for the two techniques (odds ratio for segmentectomy 0.91 (0.61–1.30), p = 0.59). Length of hospital stay and drainage duration were shorter after segmentectomy. On multivariate analysis, an American Society of Anesthesiologists score above 2 and a forced expiratory volume in one second below 80% of predicted value were significantly associated with the occurrence of complications. Conclusions The rate of complications and their grade were similar between segmentectomy and lobectomy by VATS.

scholarly journals Comprehensive analysis of in-hospital delirium after major surgical oncology procedures

2019 ◽  
Vol 14 (3) ◽  
Author(s):  
Marco Bandini ◽  
Michele Marchioni ◽  
Felix Preisser ◽  
Sebastiano Nazzani ◽  
Zhe Tian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Length Of Stay ◽  
Hospital Mortality ◽  
Lung Resection ◽  
Temporal Trends ◽  
Surgical Oncology ◽  
Population Based ◽  
Hospital Charges ◽  
Weighted Estimate ◽  
Prolonged Length

Introduction: Very few population-based assessments of delirium have been performed to date. These have not assessed the implications of delirium after major surgical oncology procedures (MSOPs). We examined the temporal trends of delirium following 10 MSOPs, as well as patient and hospital delirium risk factors. Finally, we examined the effect of delirium on length of stay, in-hospital mortality, and hospital charges. Methods: We retrospectively identified patients who underwent prostatectomy, colectomy, cystectomy, mastectomy, gastrectomy, hysterectomy, nephrectomy, oophorectomy, lung resection, or pancreatectomy within the Nationwide Inpatient Sample (2003‒2013). We yielded a weighted estimate of 3 431 632 patients. Multivariable logistic regression (MLR) analyses identified the determinants of postoperative delirium, as well as the effect of delirium on length of stay, in-hospital mortality, and hospital charges. Results: Between 2003 and 2013, annual delirium rate increased from 0.7 to 1.2% (+6.0%; p<0.001). Delirium rates were highest after cystectomy (predicted probability [PP] 3.1%) and pancreatectomy (PP 2.6%) and lowest after prostatectomy (PP 0.15%) and mastectomy (PP 0.13%). Advanced age (odds ratio [OR] 3.80), maleness (OR 1.38), and higher Charlson comorbidity index (OR 1.20), as well as postoperative complications represent risk factors for delirium after MSOPs. Delirium after MSOP was associated with prolonged length of stay (OR 3.00), higher mortality (OR 1.15) and increased in-hospital charges (OR 1.13). Conclusions: No contemporary population-based assessments of delirium after MSOP have been reported. According to our findings, delirium after MSOP has a profound impact on patient outcomes that ranges from prolonged length of stay to higher mortality and increased in-hospital charges.

Does External Pleural Suction Reduce Prolonged Air Leak After Lung Resection? Results From the AirINTrial After 500 Randomized Cases

2013 ◽  
Vol 96 (4) ◽  
pp. 1234-1239 ◽  
Author(s):  
Francesco Leo ◽  
Leonardo Duranti ◽  
Lara Girelli ◽  
Simone Furia ◽  
Andrea Billè ◽  
...  
Keyword(s):  
Lung Resection ◽  
Air Leak ◽  
Prolonged Air Leak

scholarly journals PROLONGED AIR LEAK AFTER LUNG RESECTION

2018 ◽  
Vol 3 (4) ◽  
pp. 36-40
Author(s):  
E A Korymasov ◽  
A S Benyan
Keyword(s):  
Lung Resection ◽  
Drainage System ◽  
Diagnostic Algorithm ◽  
Air Leakage ◽  
Air Leak ◽  
Prolonged Air Leak ◽  
Common Causes ◽  
Resection Line ◽  
Lung Resections

Objectives - to analyze the causes of postoperative air leak and to propose a therapeutic and diagnostic algorithm for this complication. Material and methods. The study includes the analysis of the prolonged air leak causes after various lung resections, the classification of the causes according to their affiliation, the designed definitions of basic concepts. Results. The most common causes of prolonged air leakage are the incompetence of the lung resection line, the undetected (unresolved) cause of pneumothorax, the inadequate drainage system function. Various tactical approaches to this problem were described. Depending on the effectiveness of the auxiliary techniques, the indications for repeated operations were determined. Conclusion. Knowledge of the causes of postoperative prolonged pathological air leak is the basis for the optimal management of patients after lung resection.

Sign in / Sign up

Export Citation Format

Share Document