Pleurodesis with an autologous blood patch to prevent persistent air leaks after lobectomy.
OBJECTIVE
Air leakage after pulmonary lobectomy is a well-known problem often contributing to extended hospitalization. Many techniques have been proposed to prevent and treat air leakage, but none have been proved incontrovertibly effective. We evaluated the role of an autologous blood patch after pulmonary lobectomy.


METHODS
Twenty-five patients with air leaks on the sixth postoperative day after lobectomy were enrolled in this study. They were randomly assigned to 2 groups: group A (12 patients), with 50 mL of autologous blood infused in the pleural cavity; and group B (13 patients), with 100 mL of blood infused. These 2 groups were retrospectively compared with the last 15 patients showing the presence of air leaks for at least 6 days (group C) (in this group the duration of leakage after the sixth postoperative day was compared). We recorded the duration of posttreatment air leaks and hospitalization.


RESULTS
Air leaks stopped 2.3 +/- 0.6 days after the procedure in group A, 1.5 +/- 0.6 days after the procedure in group B, and after 6.3 +/- 3.7 days in group C. The air leakage disappeared within 72 hours in all patients in groups A and B. There was a statistically significant difference in the duration of drainage between groups A and B (P = .005), groups A and C (P = .0009), and groups B and C (P = .0001), showing the effectiveness of an autologous blood patch, particularly with 100 mL of blood.


CONCLUSIONS
Management of air leaks after lobectomy with an autologous blood patch is easy, safe, and effective, and does not add costs. It may become the gold standard treatment early in the postoperative course.
Andreetti
Claudio
C
University of Rome La Sapienza, Department of Thoracic Surgery, Rome, Italy.
Venuta
Federico
F
Anile
Marco
M
De Giacomo
Tiziano
T
Diso
Daniele
D
Di Stasio
Mario
M
Rendina
Erino A
EA
Coloni
Giorgio Furio
GF
D000368:Aged; D000388:Air; D001804:Blood Transfusion, Autologous; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D018700:Pleurodesis / Q000379:methods*; D011013:Pneumonectomy / Q000009:adverse effects* / Q000379:methods; D011182:Postoperative Care; D011183:Postoperative Complications / Q000517:prevention & control*; D011336:Probability; D018570:Risk Assessment; D016896:Treatment Outcome