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A Prospective Audit of Management of Air Leaks After Pulmonary Resection Based on an Institutional Protocol of Care FREE TO VIEW

Antonio E. Martin-Ucar, MD; Eliseo Passera, MD; Roger Vaughan, MD; Gaetano Rocco, MD, FCCP
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The Price-Thomas Unit. Northern General Hospital, Sheffield, United Kingdom


Chest. 2003;124(4_MeetingAbstracts):234S-c-235S. doi:10.1378/chest.124.4_MeetingAbstracts.234S-c
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PURPOSE:  Postoperative air leaks are common after pulmonary surgery. They can determine morbidity and hospital stay. Despite this, interpretation and management is variable and mostly based on personal experience. We have conducted an audit to evaluate the incidence and management of post-operative air leaks after pulmonary resection according to a local protocol of care.

METHODS:  A prospective audit of management of postoperative air-leaks and intercostal drains in all patients undergoing pulmonary resection by two dedicated thoracic surgeons over a 5-month period. Endpoints: incidence and duration of air leak, length of drainage, hospital stay and need to re-insert additional chest drains after surgery. 8 patients undergoing pneumonectomy were excluded (none suffered bronchopleural fistulae).

RESULTS:  Of 78 patients [43 male and 35 female, median age 60 (range 20–78)years] undergoing pulmonary resection, 38 (49%) presented a postoperative air leak. The median drainage time was 3 (range 1–17) days and median hospital stay was 5 (1–52) days. Prolonged air leak (PAL) over 7 days occurred n 5 cases (6%). In two cases (2.6%) an additional chest drain was inserted at one point in the post-operative period. There was one death (1.3%) nine days after right upper lobectomy.CONCLUSIONS: While the incidence of post-operative air leaks was similar to published standards, their duration appear shortened when compared with the literature.

CLINICAL IMPLICATIONS:  Our protocol of care for the management of air-leaks and intercostals drains derived in minimal local complications.

Results in anatomical and sublobar resections

NumberAir leakDrainage timeHospital staySublobar resections4115 (37%)2 (1–15) days3 (1–16) daysAnatomical resections3723 (62%)3 (2–17) days6 (3–52) daysTotal resections7838 (49%)3 (1–17) days5 (1–52) days

DISCLOSURE:  A.E. Martin-Ucar, None.

Wednesday, October 29, 2003

12:30 PM - 2:00 PM




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