Present Situation and Progression of Prolonged Air Leak after Pulmonary Resection_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

Department of Thoracic Surgery, West China Hospital, Sichuan University, 610041, P. R. China;

Corresponding?author：

Keywords：

Pulmonary resection; Prolonged air leak; Risk factors; Treatment

DOI：

10.7507/1007-4848.20160198

Video：

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Abstract Full text Figures/Tables Video References Cited by

Prolonged air leak (PAL) is one of the most common complication in patients underwent pulmonary resection. The prevention and treatment of PAL are important for the quick recovery of these patients. In this review, we summarized systematically four aspects of PAL including the clinical definition of PAL and influence factors, common risk factors and prediction model, prevention and perioperative management, and postoperative treatment.

Citation： LIHua-sheng, MEIJian-dong, ZHAOKe-jiang, LIULun-xu. Present Situation and Progression of Prolonged Air Leak after Pulmonary Resection. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(8): 832-835. doi: 10.7507/1007-4848.20160198 Copy

1.	Bm H, Rw A. Prolonged air leak after lung resection. Current Respiratory Medicine Reviews, 2012, 8(4):280-284.
2.	Jeon H W, Kim Y D, Kye Y K, et al. Air leakage on the postoperative day:powerful factor of postoperative recurrence after thoracoscopic bullectomy. J Thorac Dis, 2016, 8(1):93-97.
3.	Brunelli A, Xiume F, Al Refai M, et al. Air leaks after lobectomy increase the risk of empyema but not of cardiopulmonary complica-tions:a case-matched analysis. Chest, 2006, 130(4):1150-1156.
4.	Okereke I, Murthy S C, Alster J M, et al. Characterization and importance of air leak after lobectomy. Ann Thorac Surg, 2005, 79 (4):1167-1173.
5.	Varela G, Jimenez M F, Novoa N, et al. Estimating hospital costs attributable to prolonged air leak in pulmonary lobectomy. Eur J Cardiothorac Surg, 2005, 27(2):329-333.
6.	Boffa D J, Allen M S, Grab J D, et al. Data from The Society of Thoracic Surgeons General Thoracic Surgery database:the surgical management of primary lung tumors. J Thorac Cardiovasc Surg, 2008, 135(2):247-254.
7.	Brunelli A, Cassivi S D, Halgren L. Risk factors for prolonged air leak after pulmonary resection. Thorac Surg Clin, 2010, 20(3):359-364.
8.	Ciccone A M, Meyers B F, Guthrie T J, et al. Long-term outcome of bilateral lung volume reduction in 250 consecutive patients with emphysema. J Thorac Cardiovasc Surg, 2003, 125(3):513-525.
9.	Rodriguez M, Jimenez M F, Hernandez M T, et al. Usefulness of conventional pleural drainage systems to predict the occurrence of prolonged air leak after anatomical pulmonary resection. Eur J Cardiothorac Surg, 2015, 48(4):612-615.
10.	杜開齊, 朱有才, 張志豪, 等.肺部手術后遷延性肺漏氣104例.武警醫學, 2009, 20(11):1039-1040.
11.	吳瑞鋒, 梁景芳, 劉金山, 等.電視胸腔鏡術后肺持續漏氣原因分析與處理.中國綜合臨床, 2012, 28(3):321-322.
12.	楊利紅, 徐旋里, 周建英.老年肺癌手術并發癥及相關因素.中國老年學雜志, 2015, (12):3320-3322.
13.	Brunelli A, Varela G, Refai M, et al. A scoring system to predict the risk of prolonged air leak after lobectomy. Ann Thorac Surg, 2010, 90(1):204-9.
14.	Rivera C, Bernard A, Falcoz P E, et al. Characterization and predic-tion of prolonged air leak after pulmonary resection:a nationwide study setting up the index of prolonged air leak. Ann Thorac Surg, 2011, 92(3):1062-1068.
15.	Orsini B, Baste J M, Gossot D, et al. Index of prolonged air leak score validation in case of video-assisted thoracoscopic surgery anatomical lung resection:results of a nationwide study based on the French national thoracic database, EPITHOR. Eur J Cardiothorac Surg, 2015, 48(4):608-611.
16.	Venuta F, Rendina E A, De Giacomo T, et al. Postoperative strate-gies to treat permanent air leaks. Thorac Surg Clin, 2010, 20(3):391-7.
17.	陳沁華. 28例全胸腔鏡下肺癌根治術患者的護理.全科護理, 2013, 11(11):2931-2932.
18.	王天佑.胸外科圍手術期肺保護的專家共識.中華外科雜志, 2009, 47(18):1361-1364.
19.	吳芳, 馬翠英, 潘旭玲.呼吸功能鍛煉在肺減容術后持續肺漏氣患者中的應用.中外健康文摘, 2014, 8:59-60.
20.	曾先文, 胡朝陽, 景其強, 等.胸腔鏡手術與傳統開胸手術治療胸部疾病的效果對比觀察.醫學理論與實踐, 2014, (13):1724-1725.
21.	陳海兵, 朱全, 陳亮.連續231例全電視胸腔鏡肺葉切除術治療非小細胞肺癌近、遠期療效分析.中國胸心血管外科臨床雜志, 2013, 20(6):673-678.
22.	潘相龍, 陳亮, 朱全. 103例全胸腔鏡解剖性肺段切除近期療效分析.南京醫科大學學報:自然科學版, 2014, 34(6):800-804.
23.	Stamenovic D, Bostanci K, Messerschmidt A, et al. Fissureless fissure-last video-assisted thoracoscopic lobectomy for all lung lobes:a better alternative to decrease the incidence of prolonged air leak? dagger. Eur J Cardiothorac Surg, 2016, Jan 19. pii:ezv455.[Epub ahead of print].
24.	譚群友, 鄧波, 康珀銘, 等. 276例單操作孔全胸腔鏡肺葉切除治療早期非小細胞肺癌的圍術期效果分析.第三軍醫大學學報, 2012, 34(21):2181-2183.
25.	張勇, 陸善偉, 王明松.單操作孔胸腔鏡技術治療早期肺癌.實用醫學雜志, 2015, (18):3066-3068.
26.	Tacconi F, Pompeo E, Mineo T C. Duration of air leak is reduced after awake nonresectional lung volume reduction surgery. Eur J Cardiothorac Surg, 2009, 35(5):822-828.
27.	Okur E, Arisoy Y, Baysungur V, et al. Prophylactic intraoperative pneumoperitoneum decreases pleural space problems after lower lobectomy or bilobectomy of the lung. Thorac Cardiovasc Surg, 2009, 57(3):160-164.
28.	Toker A, Dilege S, Tanju S, et al. Perioperative pneumoperitoneum after lobectomy——bilobectomy operations for lung cancer:a pros-pective study. Thorac Cardiovasc Surg, 2003, 51(2):93-96.
29.	胡欣春, 鄔海, 程呂歡, 等.聚乙醇酸網狀材料在自發性氣胸外科治療中的臨床研究.實用中西醫結合臨床, 2012, 12(2):29-30.
30.	楊海平, 吳駿, 孫林, 等.奈維在胸腔鏡肺大泡切除術后防止漏氣的臨床療效.中國綜合臨床, 2011, 27(4):440-442.
31.	Ikeda T, Sasaki M, Yamada N, et al. Controlling air leaks using free pericardial fat pads as surgical sealant in pulmonary resection. Ann Thorac Surg, 2015, 99(4):1170-1175.
32.	Gonfiotti A, Santini P F, Jaus M, et al. Safety and effectiveness of a new fibrin pleural air leak sealant:a multicenter, controlled, prospective, parallel-group, randomized clinical trial. Ann Thorac Surg, 2011, 92(4):1217-1225.
33.	Lopez C, Facciolo F, Lequaglie C, et al. Efficacy and safety of fibrin sealant patch in the treatment of air leakage in thoracic surgery. Minerva Chir, 2013, 68(6):559-567.
34.	Korasidis S, Andreetti C, D'andrilli A, et al. Management of residual pleural space and air leaks after major pulmonary resection. Interact Cardiovasc Thorac Surg, 2010, 10(6):923-925.
35.	Uzzaman MM, Daniel Robb J, Mhandu PC, et al. A meta-analysis assessing the benefits of concomitant pleural tent procedure after upper lobectomy. Ann Thorac Surg, 2014, 97(1):365-372.
36.	Mueller MR, Marzluf BA. The anticipation and management of air leaks and residual spaces post lung resection. J Thorac Dis, 2014, 6(3):271-284.
37.	Anegg U, Lindenmann J, Matzi V, et al. AIRFIX:the first digital postoperative chest tube airflowmetry——a novel method to quantify air leakage after lung resection. Eur J Cardiothorac Surg, 2006, 29(6):867-872.
38.	Cerfolio RJ, Bryant AS. The benefits of continuous and digital air leak assessment after elective pulmonary resection:a prospective study. Ann Thorac Surg, 2008, 86(2):396-401.
39.	Rathinam S, Bradley A, Cantlin T, et al. Thopaz Portable Suction Systems in Thoracic Surgery:an end user assessment and feedback in a tertiary unit. J Cardiothorac Surg, 2011, 6:59.
40.	Royer A M, Smith J S, Miller A, et al. Safety of Outpatient chest tube management of air leaks after pulmonary resection. Am Surg, 2015, 81(8):760-763.
41.	Lang P, Manickavasagar M, Burdett C, et al. Suction on chest drains following lung resection:evidence and practice are not aligned. Eur J Cardiothorac Surg, 2016, 49(2):611-616.
42.	Leo F, Duranti L, Girelli L, et al. Does external pleural suction reduce prolonged air leak after lung resection? Results from the AirINTrial after 500 randomized cases. Ann Thorac Surg, 2013, 96(4):1234-1239.
43.	趙永生, 劉倫旭.肺葉切除術后胸腔引流的管理.中國胸心血管外科臨床雜志, 2013, 20(3):338-342.
44.	劉瓊, 肖力.胸腔注射高滲糖水治療胸部手術后肺持續漏氣的護理.護士進修雜志, 2015, 30(22):2098-2099.
45.	張輝, 張淼, 胡正群, 等.甘露聚糖肽胸腔灌注治療持續性肺漏氣.中國實用鄉村醫生雜志, 2015, 22(10):38-39.
46.	丁君蓉, 魯敏, 史蘇霞.自體血治療肺葉切除術后持續漏氣的護理.上海護理, 2011, 11(1):34-35.
47.	Carr JA. The intracorporeal use of 2-octyl cyanoacrylate resin to control air leaks after lung resection. Eur J Cardiothorac Surg, 2011, 39(4):579-583.
48.	趙永生, 馬林, 劉倫旭.白介素-2在肺切除術后持續性肺漏氣治療中的應用.華西醫學, 2013, 28(4):571-572.
49.	劉鵬, 蔣占鑫, 席俊峰.鴉膽子油在肺癌術后肺漏氣及引流液增多治療中的作用.延安大學學報(醫學科學版), 2014, 12(3):19-21.
50.	Dooms CA, De Leyn PR, Yserbyt J, et al. Endobronchial valves for persistent postoperative pulmonary air leak:accurate monitoring and functional implications. Respiration, 2012, 84(4):329-33.
51.	Dooms CA, Decaluwe H, Yserbyt J, et al. Bronchial valve treatment for pulmonary air leak after anatomical lung resection for cancer. Eur Respir J, 2014, 43(4):1142-1148.
52.	Travaline JM, Mckenna RJ, Jr, De Giacomo T, et al. Treatment of persistent pulmonary air leaks using endobronchial valves. Chest, 2009, 136(2):355-360.
53.	魏建強, 聶文軍, 馮君.自體血胸腔內注入治療不能耐受手術患者持續肺漏氣.中國基層醫藥, 2014, (20):3183-3184.
54.	Lillegard J B, Kennedy R D, Ishitani M B, et al. Autologous blood patch for persistent air leak in children. J Pediatr Surg, 2013, 48(9):1862-1866.
55.	Karangelis D, Tagarakis G I, Daskalopoulos M, et al. Intrapleural instillation of autologous blood for persistent air leak in spontan-eous pneumothorax-is it as effective as it is safe? J Cardiothorac Surg, 2010, 5:61. doi:10.1186/1749-8090-5-61.
56.	De Giacomo T, Rendina EA, Venuta F, et al. Pneumoperitoneum for the management of pleural air space problems associated with major pulmonary resections. Ann Thorac Surg, 2001, 72(5):1716-1719.

1. Bm H, Rw A. Prolonged air leak after lung resection. Current Respiratory Medicine Reviews, 2012, 8(4):280-284.
2. Jeon H W, Kim Y D, Kye Y K, et al. Air leakage on the postoperative day:powerful factor of postoperative recurrence after thoracoscopic bullectomy. J Thorac Dis, 2016, 8(1):93-97.
3. Brunelli A, Xiume F, Al Refai M, et al. Air leaks after lobectomy increase the risk of empyema but not of cardiopulmonary complica-tions:a case-matched analysis. Chest, 2006, 130(4):1150-1156.
4. Okereke I, Murthy S C, Alster J M, et al. Characterization and importance of air leak after lobectomy. Ann Thorac Surg, 2005, 79 (4):1167-1173.
5. Varela G, Jimenez M F, Novoa N, et al. Estimating hospital costs attributable to prolonged air leak in pulmonary lobectomy. Eur J Cardiothorac Surg, 2005, 27(2):329-333.
6. Boffa D J, Allen M S, Grab J D, et al. Data from The Society of Thoracic Surgeons General Thoracic Surgery database:the surgical management of primary lung tumors. J Thorac Cardiovasc Surg, 2008, 135(2):247-254.
7. Brunelli A, Cassivi S D, Halgren L. Risk factors for prolonged air leak after pulmonary resection. Thorac Surg Clin, 2010, 20(3):359-364.
8. Ciccone A M, Meyers B F, Guthrie T J, et al. Long-term outcome of bilateral lung volume reduction in 250 consecutive patients with emphysema. J Thorac Cardiovasc Surg, 2003, 125(3):513-525.
9. Rodriguez M, Jimenez M F, Hernandez M T, et al. Usefulness of conventional pleural drainage systems to predict the occurrence of prolonged air leak after anatomical pulmonary resection. Eur J Cardiothorac Surg, 2015, 48(4):612-615.
10. 杜開齊, 朱有才, 張志豪, 等.肺部手術后遷延性肺漏氣104例.武警醫學, 2009, 20(11):1039-1040.
11. 吳瑞鋒, 梁景芳, 劉金山, 等.電視胸腔鏡術后肺持續漏氣原因分析與處理.中國綜合臨床, 2012, 28(3):321-322.
12. 楊利紅, 徐旋里, 周建英.老年肺癌手術并發癥及相關因素.中國老年學雜志, 2015, (12):3320-3322.
13. Brunelli A, Varela G, Refai M, et al. A scoring system to predict the risk of prolonged air leak after lobectomy. Ann Thorac Surg, 2010, 90(1):204-9.
14. Rivera C, Bernard A, Falcoz P E, et al. Characterization and predic-tion of prolonged air leak after pulmonary resection:a nationwide study setting up the index of prolonged air leak. Ann Thorac Surg, 2011, 92(3):1062-1068.
15. Orsini B, Baste J M, Gossot D, et al. Index of prolonged air leak score validation in case of video-assisted thoracoscopic surgery anatomical lung resection:results of a nationwide study based on the French national thoracic database, EPITHOR. Eur J Cardiothorac Surg, 2015, 48(4):608-611.
16. Venuta F, Rendina E A, De Giacomo T, et al. Postoperative strate-gies to treat permanent air leaks. Thorac Surg Clin, 2010, 20(3):391-7.
17. 陳沁華. 28例全胸腔鏡下肺癌根治術患者的護理.全科護理, 2013, 11(11):2931-2932.
18. 王天佑.胸外科圍手術期肺保護的專家共識.中華外科雜志, 2009, 47(18):1361-1364.
19. 吳芳, 馬翠英, 潘旭玲.呼吸功能鍛煉在肺減容術后持續肺漏氣患者中的應用.中外健康文摘, 2014, 8:59-60.
20. 曾先文, 胡朝陽, 景其強, 等.胸腔鏡手術與傳統開胸手術治療胸部疾病的效果對比觀察.醫學理論與實踐, 2014, (13):1724-1725.
21. 陳海兵, 朱全, 陳亮.連續231例全電視胸腔鏡肺葉切除術治療非小細胞肺癌近、遠期療效分析.中國胸心血管外科臨床雜志, 2013, 20(6):673-678.
22. 潘相龍, 陳亮, 朱全. 103例全胸腔鏡解剖性肺段切除近期療效分析.南京醫科大學學報:自然科學版, 2014, 34(6):800-804.
23. Stamenovic D, Bostanci K, Messerschmidt A, et al. Fissureless fissure-last video-assisted thoracoscopic lobectomy for all lung lobes:a better alternative to decrease the incidence of prolonged air leak? dagger. Eur J Cardiothorac Surg, 2016, Jan 19. pii:ezv455.[Epub ahead of print].
24. 譚群友, 鄧波, 康珀銘, 等. 276例單操作孔全胸腔鏡肺葉切除治療早期非小細胞肺癌的圍術期效果分析.第三軍醫大學學報, 2012, 34(21):2181-2183.
25. 張勇, 陸善偉, 王明松.單操作孔胸腔鏡技術治療早期肺癌.實用醫學雜志, 2015, (18):3066-3068.
26. Tacconi F, Pompeo E, Mineo T C. Duration of air leak is reduced after awake nonresectional lung volume reduction surgery. Eur J Cardiothorac Surg, 2009, 35(5):822-828.
27. Okur E, Arisoy Y, Baysungur V, et al. Prophylactic intraoperative pneumoperitoneum decreases pleural space problems after lower lobectomy or bilobectomy of the lung. Thorac Cardiovasc Surg, 2009, 57(3):160-164.
28. Toker A, Dilege S, Tanju S, et al. Perioperative pneumoperitoneum after lobectomy——bilobectomy operations for lung cancer:a pros-pective study. Thorac Cardiovasc Surg, 2003, 51(2):93-96.
29. 胡欣春, 鄔海, 程呂歡, 等.聚乙醇酸網狀材料在自發性氣胸外科治療中的臨床研究.實用中西醫結合臨床, 2012, 12(2):29-30.
30. 楊海平, 吳駿, 孫林, 等.奈維在胸腔鏡肺大泡切除術后防止漏氣的臨床療效.中國綜合臨床, 2011, 27(4):440-442.
31. Ikeda T, Sasaki M, Yamada N, et al. Controlling air leaks using free pericardial fat pads as surgical sealant in pulmonary resection. Ann Thorac Surg, 2015, 99(4):1170-1175.
32. Gonfiotti A, Santini P F, Jaus M, et al. Safety and effectiveness of a new fibrin pleural air leak sealant:a multicenter, controlled, prospective, parallel-group, randomized clinical trial. Ann Thorac Surg, 2011, 92(4):1217-1225.
33. Lopez C, Facciolo F, Lequaglie C, et al. Efficacy and safety of fibrin sealant patch in the treatment of air leakage in thoracic surgery. Minerva Chir, 2013, 68(6):559-567.
34. Korasidis S, Andreetti C, D'andrilli A, et al. Management of residual pleural space and air leaks after major pulmonary resection. Interact Cardiovasc Thorac Surg, 2010, 10(6):923-925.
35. Uzzaman MM, Daniel Robb J, Mhandu PC, et al. A meta-analysis assessing the benefits of concomitant pleural tent procedure after upper lobectomy. Ann Thorac Surg, 2014, 97(1):365-372.
36. Mueller MR, Marzluf BA. The anticipation and management of air leaks and residual spaces post lung resection. J Thorac Dis, 2014, 6(3):271-284.
37. Anegg U, Lindenmann J, Matzi V, et al. AIRFIX:the first digital postoperative chest tube airflowmetry——a novel method to quantify air leakage after lung resection. Eur J Cardiothorac Surg, 2006, 29(6):867-872.
38. Cerfolio RJ, Bryant AS. The benefits of continuous and digital air leak assessment after elective pulmonary resection:a prospective study. Ann Thorac Surg, 2008, 86(2):396-401.
39. Rathinam S, Bradley A, Cantlin T, et al. Thopaz Portable Suction Systems in Thoracic Surgery:an end user assessment and feedback in a tertiary unit. J Cardiothorac Surg, 2011, 6:59.
40. Royer A M, Smith J S, Miller A, et al. Safety of Outpatient chest tube management of air leaks after pulmonary resection. Am Surg, 2015, 81(8):760-763.
41. Lang P, Manickavasagar M, Burdett C, et al. Suction on chest drains following lung resection:evidence and practice are not aligned. Eur J Cardiothorac Surg, 2016, 49(2):611-616.
42. Leo F, Duranti L, Girelli L, et al. Does external pleural suction reduce prolonged air leak after lung resection? Results from the AirINTrial after 500 randomized cases. Ann Thorac Surg, 2013, 96(4):1234-1239.
43. 趙永生, 劉倫旭.肺葉切除術后胸腔引流的管理.中國胸心血管外科臨床雜志, 2013, 20(3):338-342.
44. 劉瓊, 肖力.胸腔注射高滲糖水治療胸部手術后肺持續漏氣的護理.護士進修雜志, 2015, 30(22):2098-2099.
45. 張輝, 張淼, 胡正群, 等.甘露聚糖肽胸腔灌注治療持續性肺漏氣.中國實用鄉村醫生雜志, 2015, 22(10):38-39.
46. 丁君蓉, 魯敏, 史蘇霞.自體血治療肺葉切除術后持續漏氣的護理.上海護理, 2011, 11(1):34-35.
47. Carr JA. The intracorporeal use of 2-octyl cyanoacrylate resin to control air leaks after lung resection. Eur J Cardiothorac Surg, 2011, 39(4):579-583.
48. 趙永生, 馬林, 劉倫旭.白介素-2在肺切除術后持續性肺漏氣治療中的應用.華西醫學, 2013, 28(4):571-572.
49. 劉鵬, 蔣占鑫, 席俊峰.鴉膽子油在肺癌術后肺漏氣及引流液增多治療中的作用.延安大學學報(醫學科學版), 2014, 12(3):19-21.
50. Dooms CA, De Leyn PR, Yserbyt J, et al. Endobronchial valves for persistent postoperative pulmonary air leak:accurate monitoring and functional implications. Respiration, 2012, 84(4):329-33.
51. Dooms CA, Decaluwe H, Yserbyt J, et al. Bronchial valve treatment for pulmonary air leak after anatomical lung resection for cancer. Eur Respir J, 2014, 43(4):1142-1148.
52. Travaline JM, Mckenna RJ, Jr, De Giacomo T, et al. Treatment of persistent pulmonary air leaks using endobronchial valves. Chest, 2009, 136(2):355-360.
53. 魏建強, 聶文軍, 馮君.自體血胸腔內注入治療不能耐受手術患者持續肺漏氣.中國基層醫藥, 2014, (20):3183-3184.
54. Lillegard J B, Kennedy R D, Ishitani M B, et al. Autologous blood patch for persistent air leak in children. J Pediatr Surg, 2013, 48(9):1862-1866.
55. Karangelis D, Tagarakis G I, Daskalopoulos M, et al. Intrapleural instillation of autologous blood for persistent air leak in spontan-eous pneumothorax-is it as effective as it is safe? J Cardiothorac Surg, 2010, 5:61. doi:10.1186/1749-8090-5-61.
56. De Giacomo T, Rendina EA, Venuta F, et al. Pneumoperitoneum for the management of pleural air space problems associated with major pulmonary resections. Ann Thorac Surg, 2001, 72(5):1716-1719.

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Present Situation and Progression of Prolonged Air Leak after Pulmonary Resection

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