Cargando…

Air leaks following pulmonary resection for lung cancer: is it a patient or surgeon related problem?

INTRODUCTION: Prolonged air leak (PAL) is the most common complication after partial lung resection and the most important determinant of length of hospital stay for patients post-operatively. The aim of this study was to determine the risk factors involved in developing air leaks and the consequenc...

Descripción completa

Detalles Bibliográficos
Autores principales: Elsayed, H, McShane, J, Shackcloth, M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Royal College of Surgeons 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3954324/
https://www.ncbi.nlm.nih.gov/pubmed/22943333
http://dx.doi.org/10.1308/003588412X13171221592258
_version_ 1782307458081882112
author Elsayed, H
McShane, J
Shackcloth, M
author_facet Elsayed, H
McShane, J
Shackcloth, M
author_sort Elsayed, H
collection PubMed
description INTRODUCTION: Prolonged air leak (PAL) is the most common complication after partial lung resection and the most important determinant of length of hospital stay for patients post-operatively. The aim of this study was to determine the risk factors involved in developing air leaks and the consequences of PAL. METHODS: All patients undergoing lung resection between January 2002 and December 2007 in our hospital were studied retrospectively. Univariate analysis to predict risk factors for developing post-operative air leaks included patient demographics, smoking status, pulmonary function tests, disease aetiology (benign, malignant), neoadjuvant therapy (pre-operative radiotherapy/chemotherapy), extent and type of resection, and different consultant surgeons’ practice. A logistic regression model was used for multivariate analysis. RESULTS: A total of 1,911 lung resections were performed over the 6-year study period. An air leak lasting more than 6 days post-operatively was present in 129 patients (6.7%). This included 100 out of the 1,250 patients (8%) from the lobectomy group and 29 out of the 661 patients (4.4%) from the wedge/segmentectomy group. Using the multivariate analysis, the risk factors for developing an air leak included a low predicted forced expiratory volume in 1 second (pFEV(1)) (p<0.001), performing an upper lobectomy (p=0.002) and different consultant practice (p=0.02). PAL was associated with increased length of stay (p<0.0001), in-hospital mortality (p=0.003) and intensive care unit readmission (p=0.05). CONCLUSIONS: Air leaks after pulmonary resections were at an acceptable rate in our series. Particular patients are at a higher risk but meticulous surgical technique is vital in reducing their incidence. Our study shows that pFEV(1)is the strongest predictor of post-operative air leaks.
format Online
Article
Text
id pubmed-3954324
institution National Center for Biotechnology Information
language English
publishDate 2012
publisher Royal College of Surgeons
record_format MEDLINE/PubMed
spelling pubmed-39543242014-03-19 Air leaks following pulmonary resection for lung cancer: is it a patient or surgeon related problem? Elsayed, H McShane, J Shackcloth, M Ann R Coll Surg Engl Cardiothoracic Surgery INTRODUCTION: Prolonged air leak (PAL) is the most common complication after partial lung resection and the most important determinant of length of hospital stay for patients post-operatively. The aim of this study was to determine the risk factors involved in developing air leaks and the consequences of PAL. METHODS: All patients undergoing lung resection between January 2002 and December 2007 in our hospital were studied retrospectively. Univariate analysis to predict risk factors for developing post-operative air leaks included patient demographics, smoking status, pulmonary function tests, disease aetiology (benign, malignant), neoadjuvant therapy (pre-operative radiotherapy/chemotherapy), extent and type of resection, and different consultant surgeons’ practice. A logistic regression model was used for multivariate analysis. RESULTS: A total of 1,911 lung resections were performed over the 6-year study period. An air leak lasting more than 6 days post-operatively was present in 129 patients (6.7%). This included 100 out of the 1,250 patients (8%) from the lobectomy group and 29 out of the 661 patients (4.4%) from the wedge/segmentectomy group. Using the multivariate analysis, the risk factors for developing an air leak included a low predicted forced expiratory volume in 1 second (pFEV(1)) (p<0.001), performing an upper lobectomy (p=0.002) and different consultant practice (p=0.02). PAL was associated with increased length of stay (p<0.0001), in-hospital mortality (p=0.003) and intensive care unit readmission (p=0.05). CONCLUSIONS: Air leaks after pulmonary resections were at an acceptable rate in our series. Particular patients are at a higher risk but meticulous surgical technique is vital in reducing their incidence. Our study shows that pFEV(1)is the strongest predictor of post-operative air leaks. Royal College of Surgeons 2012-09 /pmc/articles/PMC3954324/ /pubmed/22943333 http://dx.doi.org/10.1308/003588412X13171221592258 Text en Copyright © 2013 Royal College of Surgeons http://creativecommons.org/licenses/by/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Cardiothoracic Surgery
Elsayed, H
McShane, J
Shackcloth, M
Air leaks following pulmonary resection for lung cancer: is it a patient or surgeon related problem?
title Air leaks following pulmonary resection for lung cancer: is it a patient or surgeon related problem?
title_full Air leaks following pulmonary resection for lung cancer: is it a patient or surgeon related problem?
title_fullStr Air leaks following pulmonary resection for lung cancer: is it a patient or surgeon related problem?
title_full_unstemmed Air leaks following pulmonary resection for lung cancer: is it a patient or surgeon related problem?
title_short Air leaks following pulmonary resection for lung cancer: is it a patient or surgeon related problem?
title_sort air leaks following pulmonary resection for lung cancer: is it a patient or surgeon related problem?
topic Cardiothoracic Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3954324/
https://www.ncbi.nlm.nih.gov/pubmed/22943333
http://dx.doi.org/10.1308/003588412X13171221592258
work_keys_str_mv AT elsayedh airleaksfollowingpulmonaryresectionforlungcancerisitapatientorsurgeonrelatedproblem
AT mcshanej airleaksfollowingpulmonaryresectionforlungcancerisitapatientorsurgeonrelatedproblem
AT shackclothm airleaksfollowingpulmonaryresectionforlungcancerisitapatientorsurgeonrelatedproblem