Management of residual spaces after lung resections and air leaks: Ultrasound and pneumoperitoneum

Interact Cardiovasc Thorac Surg. 2022 Jun 15;35(1):ivac035. doi: 10.1093/icvts/ivac035.

Abstract

Prolonged chest tube drainage is one of the most common postoperative complications of pulmonary resections; it is related to complications such as residual pleural spaces or continuous alveolar air leaks. We retrospectively evaluated the efficacy of artificial intraoperative pneumoperitoneum in the treatment of such complications after lung resections. The presence of a residual space associated with prolonged air leaks can be difficult to treat, exposes the patient to a high risk of infection, prolongs hospitalization, and in some cases mandates reoperation. Between October 2016 and March 2020, four patients underwent pneumoperitoneum. The obliteration of the pleural cavity and the absence of air leaks were observed in 3 patients; only 1 patient was discharged with a Heimlich valve. Artificial intraoperative pneumoperitoneum is a safe and simple procedure. It decreases the duration of chest drainage and of the hospital stay; however, further studies are needed to corroborate our data. The learning curve for this technique may be relatively short.

Keywords: air-leaks; pneumoperitoneum; residual pleural space; ultrasound.

MeSH terms

  • Chest Tubes
  • Humans
  • Lung
  • Pneumonectomy / adverse effects
  • Pneumonectomy / methods
  • Pneumoperitoneum* / diagnostic imaging
  • Pneumoperitoneum* / etiology
  • Retrospective Studies