Outcome of pleurodesis using different agents in management prolonged air leakage following lung resection

Jabłoński, Sławomir; Kordiak, Jacek; Wcisło, Szymon; Terlecki, Artur; Misiak, Piotr; Santorek-Strumiłło, Edyta; Lazarek, Jerry; Kozakiewicz, Marcin

doi:10.1111/crj.12509

Cited by 13 publications

(14 citation statements)

References 26 publications

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“… 16 There are also reports on acute respiratory distress syndrome after talc or OK-432 administration. 14 , 15 Moreover, another study showed that pleurodesis could induce acute exacerbation of IP, 17 which is why our institution avoids performing pleurodesis as much as possible among those with IP. Pleurodesis using an autologous blood patch had been reported to be safer and result in fewer complications than chemical pleurodesis.…”

Section: Discussionmentioning

confidence: 96%

“…16 There are also reports on acute respiratory distress syndrome after talc or OK-432 administration. 14,15 Moreover, another study showed that pleurodesis could induce acute A, Difference in the decline in the vital capacity (VC) between patients who used talc and those who did not use talc. Among patients who underwent pleurodesis, the decline in VC at 6 months postoperatively in patients who used talc and those who did not use talc were À12.9% AE 4.2% and À22.2% AE 2.8%, respectively (P ¼ .076).…”

Section: Discussionmentioning

confidence: 99%

“…Pleurodesis remains among the effective strategies for prolonged air leak 7 , 8 and chylothorax 13 ; however, several complications and disadvantages for pleurodesis have been reported. 14 , 15 , 16 For instance, 1 study revealed severe pain or fever after injection of chemical materials. 16 There are also reports on acute respiratory distress syndrome after talc or OK-432 administration.…”

Section: Discussionmentioning

confidence: 99%

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Impact of postoperative pleurodesis on pulmonary function after lung segmentectomy

et al. 2021

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Objective: Pleurodesis is among several treatment strategies for postoperative alveolo-pleural fistula (APF) after lung resection. Accordingly, the present study aimed to determine the influence of pleurodesis on postoperative pulmonary function.Methods: Patients who underwent anatomical segmentectomy between January 2009 and March 2020 and pulmonary function tests 6 and 12 months after initial surgery were included in this study. Differences in pulmonary function decline between patients who did and did not undergo pleurodesis were compared.Results: Among the 319 patients included, 39 (12.2%) underwent pleurodesis. Among patients who did not receive pleurodesis, there were no difference in decline of vital capacity at 6 months (À13.7% AE 1.1% vs À11.2% AE 0.7%; P ¼ .063) and 12 months (À10.7% AE 1.3% vs À9.5% AE 0.7%; P ¼ .391) after surgery between patients who had APF on postoperative day 2 and those who did not. Patients who received pleurodesis had a significantly larger decline in vital capacity at 6 months (À19.4% AE 2.4% vs À13.7% AE 1.1%; P ¼ .015) and 12 months (À16.2% AE 1.6% vs À10.7% AE 1.3%; P ¼ .010) after surgery compared with those who had APF on postoperative day 2 and did not receive pleurodesis. There were no significant differences in decline of forced expiratory volume in 1 second.

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Section: Discussionmentioning

confidence: 96%

“…16 There are also reports on acute respiratory distress syndrome after talc or OK-432 administration. 14,15 Moreover, another study showed that pleurodesis could induce acute A, Difference in the decline in the vital capacity (VC) between patients who used talc and those who did not use talc. Among patients who underwent pleurodesis, the decline in VC at 6 months postoperatively in patients who used talc and those who did not use talc were À12.9% AE 4.2% and À22.2% AE 2.8%, respectively (P ¼ .076).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Impact of postoperative pleurodesis on pulmonary function after lung segmentectomy

et al. 2021

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“…Several treatment options have been proposed for postoperative air leaks. Chemical pleurodesis with different agents such as talc, tetracyclines or iodine, prolonged chest tube drainage using a Heimlich valve system, insertion of endobronchial valves, or surgical intervention have been previously described 8–10 …”

Section: Introductionmentioning

confidence: 99%

“…Chemical pleurodesis with different agents such as talc, tetracyclines or iodine, prolonged chest tube drainage using a Heimlich valve system, insertion of endobronchial valves, or surgical intervention have been previously described. [8][9][10] Autologous blood pleurodesis (ABP) was introduced 33 years ago as a treatment option in patients with pneumothorax. 11 Several theories have tried to explain the mechanism of action; one suggested that blood initiates an intrapleural inflammatory reaction leading to pleurodesis, while another theory supported the idea of the leaking airway being directly sealed by the blood.…”

Section: Introductionmentioning

confidence: 99%

Autologous blood pleurodesis for the treatment of postoperative air leaks. A systematic review and meta‐analysis

et al. 2021

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Background Postoperative air leaks are a common complication after lung surgery. They are associated with prolonged hospital stay, increased postoperative pain and treatment costs. The treatment of prolonged air leaks remains controversial. Several treatments have been proposed including different types of sealants, chemical pleurodesis, or early surgical intervention. The aim of this review was to analyze the impact of autologous blood pleurodesis in a systematic way. Methods A systematic review of the literature was conducted until July 2020. Studies with more than five adult patients undergoing lung resections were included. Studies in patients receiving blood pleurodesis for pneumothorax were excluded. The search strategy included proper combinations of the MeSH terms “air leak”, “blood transfusion” and “lung surgery”. Results Ten studies with a total of 198 patients were included in the analysis. The pooled success rate for sealing the air leak within 48 h of the blood pleurodesis was 83.7% (95% CI: 75.7; 90.3). The pooled incidence of the post‐interventional empyema was 1.5%, with a pooled incidence of post‐interventional fever of 8.6%. Conclusions Current evidence supports the idea that autologous blood pleurodesis leads to a faster healing of postoperative air leaks than conservative treatment. The complication rate is very low. Formal recommendations on how to perform the procedure are not possible with the current evidence. A randomized controlled trial in the modern era is necessary to confirm the benefits.

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The Society of Thoracic Surgeons Expert Consensus Document on the Management of Pleural Drains After Pulmonary Lobectomy

Kent,

Mitzman,

Diaz-Gutierrez

et al. 2024

The Annals of Thoracic Surgery

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Outcome of pleurodesis using different agents in management prolonged air leakage following lung resection

Cited by 13 publications

References 26 publications

Impact of postoperative pleurodesis on pulmonary function after lung segmentectomy

Impact of postoperative pleurodesis on pulmonary function after lung segmentectomy

Autologous blood pleurodesis for the treatment of postoperative air leaks. A systematic review and meta‐analysis

The Society of Thoracic Surgeons Expert Consensus Document on the Management of Pleural Drains After Pulmonary Lobectomy

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