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. 2023 Feb 28;15(2):858-865.
doi: 10.21037/jtd-22-623. Epub 2022 Oct 17.

Prolonged air leak after segmentectomy: incidence and risk factors

Michael R Gooseman #  1 , Alessandro Brunelli #  2 , Nilanjan Chaudhuri  2 , Richard Milton  2 , Peter Tcherveniakov  2 , Kostas Papagiannopoulos  2 , Laura Valuckiene  2
Affiliations

Prolonged air leak after segmentectomy: incidence and risk factors

Michael R Gooseman et al. J Thorac Dis. .

Abstract

Background: We designed this study to investigate the rate and risk factors of prolonged air leak (PAL) in patients undergoing pulmonary segmentectomy in our unit.

Methods: We performed a retrospective cohort study on 191 patients undergoing pulmonary segmentectomy (January 2017-August 2021). A PAL was defined as an air leak >5 days.

Results: One hundred and sixty-eight segmentectomies were performed using video-assisted thoracoscopic surgery (VATS), 13 were open operations and 10 were robotic. PAL occurred in 36 patients (19%). Their average post-operative stay was 2.4 days longer than those without PAL. Logistic regression analysis showed that a low preoperative carbon monoxide lung diffusion capacity (DLCO) (OR 0.98, P<0.001), low body mass index (BMI) (OR 0.95, P=0.002) and the performance of complex segmentectomies (OR 2.2, P<0.001). were significantly associated with PAL.

Conclusions: Pulmonary segmentectomies are associated with a not negligible risk of PAL when using real world data, especially in patients with compromised pulmonary function and after complex segmentectomies. This finding is useful to inform the decision-making process.

Keywords: Pulmonary segmentectomy; outcome; prolonged air leak (PAL).

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-22-623/coif). The special series “Prolonged Air Leak after Lung Surgery: Prediction, Prevention and Management” was sponsored by Bard Limited. Bard Limited has no interference on the contents of the special series. AB served as the unpaid Guest Editor of the series and serves as an unpaid associate editor-in-chief of Journal of Thoracic Disease. AB serves as ESTS President and he received payments for participation at Advisory Board with Astra Zeneca, Medtronic, Ethicon and Roche in the past 36 months. KP serves as an unpaid editorial board member of Journal of Thoracic Disease from November 2021 to October 2023 and received consulting fee for participation at Advisory Board with Ethicon in the past 36 months. The authors have no other conflicts of interest to declare.

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