Prolonged air leak is quite a common pulmonary complication after pulmonary lobectomy and can be treated conservatively. This complication significantly prolongs the length of hospitalization (P<0.01). We also conclude that COPD increases the risk of an air leak persisting for longer than 7 days.

Our non-randomized study showed that side-to-side LS technique is the preferred method of intrathoracic oesophagogastric anastomosis due to a decreased overall anastomotic leak rate and anastomotic stricture formation compared with HS technique.

Postlobectomy atelectasis is an important postoperative complication. Patients with COPD and those undergoing RUL are at higher risk of this complication. Although often isolated, PLA is associated with longer hospital stay.

† Extracorporeal circulation and hypothermia can induce platelet activation and dysfunction in cardiac surgery. † Cangrelor, a shortacting platelet adenosinediphosphate receptor blocker, was used to prevent platelet activation in ex vivo and in vivo models of extracorporeal circulation. † Cangrelor reversibly reduced platelet activation, providing a potential pharmacological strategy to reduce bleeding complications. Background. Extracorporeal circulation (ECC) and hypothermia are routinely used in cardiac surgery to maintain stable circulatory parameters and to increase the ischaemic tolerance of the patient. However, ECC and hypothermia cause platelet activation and dysfunction possibly followed by a devastating coagulopathy. Stimulation of the adenosinediphosphate (ADP) receptor P 2 Y 12 plays a pivotal role in platelet activation. This experimental study tested P 2 Y 12 receptor blockade as an approach to protect platelets during ECC. Methods. Human blood was treated with the short-acting P 2 Y 12 blocker cangrelor (1 mM, t 1/2 ,5 min) or the P 2 Y 12 inhibitor 2-MeSAMP (100 mM) and circulated in an ex vivo ECC model at normothermia (378C) and hypothermia (288C). Before and after circulation, markers of platelet activation and of coagulation (thrombin-antithrombin complex generation) were analysed. During hypothermic ECC in pigs, the effect of reversible P 2 Y 12 blockade on platelet function was evaluated by cangrelor infusion (0.075 mg kg 21 min 21). Results. During ex vivo hypothermic ECC, P 2 Y 12 blockade inhibited platelet granule release (P,0.01), platelet-granulocyte binding (P,0.05), and platelet loss (P,0.001), whereas no effects on platelet-ECC binding, platelet CD42ba expression, glycoprotein IIb/IIIa activation, or thrombin-antithrombin complex generation were observed. During hypothermic ECC in pigs, cangrelor inhibited platelet-fibrinogen binding (P,0.05) and ADP-induced platelet aggregation (P,0.001). Platelet function was rapidly restored after termination of cangrelor infusion. Conclusions. P 2 Y 12 blockade by cangrelor prevents platelet activation during ECC and hypothermia. Owing to its short half-life, platelet inhibition can be well controlled, thus potentially reducing bleeding complications. This novel pharmacological strategy has the potential to reduce complications associated with ECC and hypothermia.