title: Prolonged air leak following lobectomy can be predicted in lung cancer patients.
abstract: OBJECTIVE
  The purpose of this study was to identify the factors associated with prolonged air leak (PAL) following pulmonary lobectomy for lung cancer.
  
  
  METHODS
  The data of 146 patients who underwent pulmonary lobectomy for lung cancer between August 2010 and July 2015 were retrospectively reviewed. Air leaks were assessed daily by a visual evaluation and were categorized as follows: forced expiratory only (Grade 1), expiratory only (Grade 2), or continuous (Grade 3). Logistic regression analyses were performed to identify the predictors of PAL (>5 days).
  
  
  RESULTS
  PAL occurred in 23 patients (16%). An air leak at rest (Grade ≥ 2) was detected on postoperative day (POD) 1 in 48% of the patients with PAL and 7% of the patients without PAL. A univariate analysis demonstrated that PAL was significantly associated with male sex, a smoking history of ≥ 40 pack years, a serum albumin level of ≤4.0 mg/dL, and an air leak on POD1 (Grade ≥ 2). A multivariate analysis demonstrated that a serum albumin level of ≤4.0 mg/dL (p = 0.027) and an air leak on POD1 (p = 0.006) were independent predictors of PAL. PAL occurred in 75% of the patients with these two risk factors.
  
  
  CONCLUSIONS
  The preoperative serum albumin level and the presence of a visually evaluated air leak on POD1 may be useful indicators for the perioperative management of air leaks.
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachidori-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Okada
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachidori-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Shimada
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachidori-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Daishiro
authors.initials: D
authors.lastname: Kato
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachidori-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Tsunezuka
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachidori-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan. mainoue@koto.kpu-m.ac.jp.
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Inoue
mesh_terms: D000368:Aged; D000388:Air; D057868:Anastomotic Leak / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D015415:Biomarkers / Q000097:blood; D005260:Female; D005544:Forecasting; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis; D012737:Sex Factors; D012907:Smoking; D013997:Time Factors
chemical_list: D015415:Biomarkers; D012709:Serum Albumin
keywords: Complications; Lung cancer; Nutrition; Prolonged air leak; Surgery