title: Air leaks following pulmonary resection for malignancy: risk factors, qualitative and quantitative analysis.
abstract: Air leaks are a common complication of pulmonary resection. The aims of this study were to analyze risk factors for postoperative air leak and to evaluate the role of air leak measurement in identifying patients at increased risk for cardiorespiratory morbidity and prolonged air leak. From March to December 2009, 142 consecutive patients underwent pulmonary resection for malignancy and were prospectively followed up. Preoperative and intraoperative risk factors for air leak were evaluated. Air leaks were qualitatively and quantitatively labeled twice daily. There were 52 (36.6%) patients who had an air leak on day 1, and 32 (22.5%) who had an air leak on day 2. Air leak was ≥180 ml/min in 12 (37.5%) of these patients. Independent predictors of air leak on day 2 included type of pulmonary resection, presence of adhesions, and incomplete fissures. Cardiorespiratory morbidity was significantly higher (34.4%) in patients who experienced air leak on day 2 than in those who did not (10.9%) (P=0.002). Nine (75%) out of 12 patients with air leak ≥180 ml/min on day 2 had prolonged air leak (greater than five days) (P=0.0001).
authors.affiliation: Department of Clinical and Biological Sciences, Thoracic Surgery Unit, University of Turin, San Luigi Hospital, 10043 Orbassano, Turin, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Billé
authors.forename: Piero
authors.initials: P
authors.lastname: Borasio
authors.forename: Mara
authors.initials: M
authors.lastname: Gisabella
authors.forename: Luca
authors.initials: L
authors.lastname: Errico
authors.forename: Paolo
authors.initials: P
authors.lastname: Lausi
authors.forename: Elena
authors.initials: E
authors.lastname: Lisi
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Barattoni
authors.forename: Francesco
authors.initials: F
authors.lastname: Ardissone
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D006331:Heart Diseases / Q000209:etiology; D006801:Humans; D007558:Italy; D008175:Lung Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000209:etiology* / Q000401:mortality; D013510:Pulmonary Surgical Procedures / Q000009:adverse effects* / Q000401:mortality; D012120:Respiration Disorders / Q000209:etiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D000267:Tissue Adhesions; D016896:Treatment Outcome; D055815:Young Adult