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Eur J Cardiothorac Surg 2005;27:334-336
© 2005 Elsevier Science NL


Predictors of prolonged air leak following pulmonary lobectomy

Alan J. Stolz*, Jan Schützner, Robert Lischke, Jan Simonek, Pavel Pafko

3rd Deptartment of Surgery, Charles University, University Hospital Motol, Kuvalu 84, Prague 15000, Czech Republic

Received 18 August 2004; received in revised form 4 November 2004; accepted 8 November 2004.

* Corresponding author. Tel.: +420 2 2443 8001; fax: +420 2 2443 8020. (E-mail: stolz{at}seznam.cz).

Objective: To predict risk factors of a prolonged air leak following pulmonary lobectomy. Methods: From January 2003 to March 2004, 134 patients (95 male, mean age 66±7.7 years) underwent pulmonary lobectomy for lung tumor. Prolonged air leak (PAL) was defined as an air leak lasting 7 days or more of postoperative chest tube drainage. Chronic obstructive pulmonary disease (COPD) was defined as an FEV1 of <70% predicted and an FEV1/FVC ratio <70% based on the results of a preoperative pulmonary function test. Results: PAL occurred in 13 (9.7%) patients and it lasted 10.4±3.2 days. Eleven out of 13 patients with PAL were identified with this co-morbidity only. There was not reoperation for PAL. Differences in age, gender, exposure to neoadjuvant chemotherapy, body mass index (BMI) and type of lobectomy were not statistically significant. COPD remained the only variable predicted for PAL (P<0.05). Conclusions: Prolonged air leak is quite a common pulmonary complication after pulmonary lobectomy and can be treated conservatively. This complication significantly prolongs the length of hospitalization (P<0.01). We also conclude that COPD increases the risk of an air leak persisting for longer than 7 days.

Key Words: Pulmonary lobectomy • Prolonged air leak • Risk factors




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