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Management of residual pleural space and persistent airleak after major lung resection

Kalliopi Athanassiadi, Ioannis Alevizakis, Nikolaos Papakonstantinou, Stamatios Kakaris
European Respiratory Journal 2016 48: PA4848; DOI: 10.1183/13993003.congress-2016.PA4848
Kalliopi Athanassiadi
1Thoracic Surgery, General Hospital “EVANGELISMOS”, Athens, Greece
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Ioannis Alevizakis
1Thoracic Surgery, General Hospital “EVANGELISMOS”, Athens, Greece
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Nikolaos Papakonstantinou
1Thoracic Surgery, General Hospital “EVANGELISMOS”, Athens, Greece
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Stamatios Kakaris
2Thoracic Surgery, General Hospital for Chest Diseases, Athens, Greece
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Abstract

OBJECTIVE: Residual space and persistent air leak is the most common complication after lung resection, requiring additional treatment and hospital stay. The aim of this retrospective study is to assess the role of an anteriorly placed Pezzer catheter in order to treat prolonged alveolar air leakage and apical residual space after lung surgery.

MATERIAL: During the last 7 years, out of 853 patients submitted to upper lobectomy/ bilobectomy for NSCLC, Lung Volume Reduction (LVR) for emphysema or reoperation, 79 (9.2%) experienced pleural space problems associated with prolonged air leak (>7days). Patients were divided into 2 groups: (A) with anterior Petzer catheter (n=52) and (B) (n=27) treated with reoperation or Heimlich valve, according to the surgeon's preference. Duration of drainage, length of hospital stay and the need of additional interventions to treat the persistent postoperative alveolar leak were compared.

RESULTS: No differences were found in the 2 groups concerning age, gender, type of resection, location (left/right). A significant reduction of the duration of drainage and of the length of the postoperative in-hospital stay was found in Group A compared to Group B. Obliteration of the pleural space was observed in all cases of Group A in a mean time of 2 days (range 1 to 4 days, while 4 patients of Group B were discharged with a residual pleural space.

CONCLUSIONS: Our experience supports the use of an anterior Petzer catheter connected to water seal, whenever a space problem associated with prolonged air leak occurs. It reduces significantly the duration of the intrapleural drainages and the length of the in-hospital stay. The procedure is effective, safe, and easy to perform.

  • COPD - management
  • Surgery
  • Thoracic oncology
  • Copyright ©the authors 2016
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Management of residual pleural space and persistent airleak after major lung resection
Kalliopi Athanassiadi, Ioannis Alevizakis, Nikolaos Papakonstantinou, Stamatios Kakaris
European Respiratory Journal Sep 2016, 48 (suppl 60) PA4848; DOI: 10.1183/13993003.congress-2016.PA4848

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Management of residual pleural space and persistent airleak after major lung resection
Kalliopi Athanassiadi, Ioannis Alevizakis, Nikolaos Papakonstantinou, Stamatios Kakaris
European Respiratory Journal Sep 2016, 48 (suppl 60) PA4848; DOI: 10.1183/13993003.congress-2016.PA4848
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