Original ArticlesA prospective algorithm for the management of air leaks after pulmonary resection
Section snippets
Patients and methods
Between July 1, 1996, and April 30, 1997, 101 consecutive patients underwent elective pulmonary resection by a single surgeon (R.J.C.) at The University of Alabama at Birmingham. Patients who had pulmonary resection performed by video thoracoscopy or thoracotomy were included in the trial. Any patient who had lung volume reduction surgery, pneumonectomy, or pulmonary resection with a bronchoplastic procedure or sleeve resection was excluded. All patients had the algorithm shown in Fig 1 applied
Results
The median age at the time of pulmonary resection in these 101 patients (67 men and 34 women) was 60 years (range, 25 to 87 years). Sixty-three patients had preexisting conditions, which were a previous malignancy in 18, congestive heart failure in 18, hypertension in 16, diabetes in 10, liver transplantation in 3, heart transplantation in 2, and upper extremity fascitis with sepsis, lymphoma, human immunodeficiency virus, pregnancy, Wegener granulomatosis, and pericarditis in 1 each.
Comment
Formation of air leaks after pulmonary resection is an extremely common problem and can prolong hospitalization. Despite its frequency, there is little objective data on how air leaks should be treated. Most experts believe that wall suction is the best treatment 1, 2, 3, 4. New products are currently being developed to help treat air leaks in the operating room, but some of these are expensive and require special equipment (patches, glues, and sealants). Our goal was to develop a simple,
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