Characterization and Prediction of Prolonged Air Leak After Pulmonary Resection: A Nationwide Study Setting Up the Index of Prolonged Air Leak

Rivera, Caroline; Bernard, Alain; Falcoz, Pierre‐Emmanuel; Thomas, Philippe; Schmidt, Aurélie; Bénard, S.; Vicaut, Éric; Dahan, M.

doi:10.1016/j.athoracsur.2011.04.033

Cited by 120 publications

(93 citation statements)

References 25 publications

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“…A number of studies have assessed the risk factors of PAL. Male patients (5,17), patients with preoperative pulmonary dysfunction (such as emphysema and COPD) (8,18,19), pleural adhesion and less developed fissure (14,20) were prone to have PAL. The operation performed by different surgeons would also affect the incidence of PAL (4).…”

Section: Discussionmentioning

confidence: 99%

“…The two most popular definitions of PAL are air leak >5 or ≥7 days after surgery (2,5,14,15). Current opinion prefers to consider an air leak as prolonged if it increased the length of an otherwise uncomplicated postoperative hospitalization (14).…”

Section: Discussionmentioning

confidence: 99%

“…According to previous studies, the incidence of PAL was approximately 10% (2,3). Several risk factors of PAL have been identified, including age, body mass index (BMI), surgeons and surgical site (4,5).…”

Section: Introductionmentioning

confidence: 99%

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Prolonged air leak after video-assisted thoracic surgery lung cancer resection: risk factors and its effect on postoperative clinical recovery

et al. 2017

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Background: Prolonged air leak (PAL) is one of the most common postoperative complications after pulmonary resection. The aim of this study was to reveal the incidence and risk factors of PAL in videoassisted thoracic surgery (VATS) lung cancer resection, and to evaluate the effect of PAL on postoperative complications, postoperative length of stay (PLOS), and medical costs. Methods: Continuous patients who underwent VATS major pulmonary resection for lung cancer betweenJanuary 2014 and December 2015 were studied. Clinical data of these patients were obtained from the Western China Lung Cancer Database. PAL was defined as air leak more than 5 days after surgery. The risk factors for PAL were analyzed, as well as the effect of PAL on postoperative clinical recovery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prolonged air leak after video-assisted thoracic surgery lung cancer resection: risk factors and its effect on postoperative clinical recovery

et al. 2017

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“…Additional risk factors that have been described include reduced diffusing capacity [9] [12], upper resections or bilobectomy [5], pleural adhesions [5] [12], relatively lower BMI [13] [14], increased dyspnea score [14], concurrent pneumothorax [9] [10], lobectomy [10] [14], preoperative inhaled or systemic steroid use [10] [15], radiologic findings of severe emphysema [8], and histopathologic findings of emphysema [8].…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, they are more time consuming and costly [19]. In order to identify patients at increased risk of PAL who may benefit from the use of intraoperative preventative techniques, several studies have identified risk factors for PAL and devised scoring systems to risk stratify patients [12] [13] [14].…”

Section: Introductionmentioning

confidence: 99%

Incidence Risk and Independent Predictors of Prolonged Air Leak in 269 Consecutive Pulmonary Resection Patients over Nine Months: A Single-Center Retrospective Cohort Study

Drewbrook¹,

Das²,

Mousadoust³

et al. 2016

OJTS

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Introduction: Prolonged air leak (PAL) is a common complication following pulmonary resection. It is associated with pneumonia, empyema, increased length of hospital stay and health-care costs. Intraoperative techniques have been developed to mitigate the risk of developing a PAL, but for their use to be efficient, identification of patients at risk for PAL is necessary. Aim: To determine the incidence of PAL following lobectomy and lesser pulmonary resections, risk factors for development of PALs, and the impact of PAL on hospital stay and readmission rates. Methods: The following variables were analyzed as PAL risk factors: patient characteristics of age, sex, body mass index (BMI), forced minute expiratory volume and capacity ratio (FEV1 and FEV1/FVC), diffusion capacity (DCLO), and transplant recipient status. Validated scoring systems included the Charlson Comorbidity Index (CCI), Medical Research Council (MRC) dyspnea score, and Eastern Cooperative Oncology Group (EGOC) score. Surgical factors included surgical technique, unplanned conversion from video-assisted thoracoscopic surgery (VATS) to thoracotomy, location and extent of resection, presence of adhesions, completeness of fissures, and method of fissure completion. Length of hospital stay and readmission rates were analyzed. Statistical tests performed on the data include univariate and multivariate logistic regression analyses. Results: Over the 9-month study duration there were 269 lung resections, of which 31 (11.52%) had an air leak lasting longer than 5 days. Mean length of stay in hospital was significantly longer in patients with PAL compared to the control group (13 vs 5 days, P < 0.001). Significant risk factors for PAL from multivariate 34planned conversion from video-assisted thoracoscopic surgery (VATS) to thoracotomy (P = 0.023). Conclusion: The incidence of PAL in our study population is similar to that found in previous studies. PAL prolongs hospital length of stay. Normal BMI, right upper lobectomy, and unplanned conversion from VATS to thoracotomy are risk factors for PAL.

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Preoperative undernutrition predicts postoperative complications of acute empyema

Sakai

Azuma

Koezuka

et al. 2021

Health Science Reports

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Introduction Surgery for acute empyema is associated with postoperative complications and relapse. Establishing a predictor for postoperative complications may improve prognosis. Objectives To demonstrate undernutrition as a predictor of complications after surgery for acute empyema. Methods We retrospectively analyzed 52 consecutive patients who underwent surgery for acute empyema from 2004 to 2019 and validated the correlation of undernutrition with serum albumin level, patient characteristics, hospital stay, and postoperative complications. Results The median preoperative serum albumin level was 2.4 g/dL (range: 1.1‐3.4). The levels in all patients were lower than the standard value (3.5 g/dL). Patients were divided into two groups based on the median serum albumin levels: the low serum albumin level group (group L, n = 28) and the high serum albumin level group (group H, n = 24). Group L patients were significantly older (64.5 vs 52.9 years, P = .002), had lower median body mass index (21.0 vs 24.2, P = .008), and significantly had Streptococcus anginosus group as the causative bacteria (50% vs 21%, P = .044). Their hospitalization duration was significantly longer (28.1 vs 14.8 days, P < .001), and postoperative complications were significant or tended to be more frequent (all incidence; 11 (39%) vs 2 (8%), P = .012, respiratory‐related; 7 (25%) vs 1 (4%), P = .056) in group L. Further analyses revealed that other undernutrition indicators also correlated with postoperative complications. Conclusions Preoperative serum albumin level is a valid predictor of complications after surgery for acute empyema. Preoperative nutrition management for empyema patients may reduce the occurrence of postoperative complications.

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Characterization and Prediction of Prolonged Air Leak After Pulmonary Resection: A Nationwide Study Setting Up the Index of Prolonged Air Leak

Cited by 120 publications

References 25 publications

Prolonged air leak after video-assisted thoracic surgery lung cancer resection: risk factors and its effect on postoperative clinical recovery

Prolonged air leak after video-assisted thoracic surgery lung cancer resection: risk factors and its effect on postoperative clinical recovery

Incidence Risk and Independent Predictors of Prolonged Air Leak in 269 Consecutive Pulmonary Resection Patients over Nine Months: A Single-Center Retrospective Cohort Study

Preoperative undernutrition predicts postoperative complications of acute empyema

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