Effectiveness of pleurodesis for postoperative air leaks after lung resection

J Cardiothorac Surg. 2024 Jan 2;19(1):2. doi: 10.1186/s13019-023-02444-6.

Abstract

Background: Pleurodesis is often performed for air leaks; however, the ideal materials and timing of the procedure remain controversial. We investigated the efficacy of pleurodesis using different materials and timing.

Methods: We retrospectively reviewed 913 consecutive patients who underwent segmentectomy or lobectomy for non-small cell lung cancer between 2014 and 2021. Pleurodesis efficacy was assessed on the day of chest tube removal.

Results: Eighty-six patients (9%) underwent pleurodesis for postoperative air leaks. Pleurodesis was performed on a median of postoperative day (POD) 5. Talc was the most frequently used material (n = 52, 60%), followed by autologous blood patches (n = 20, 23%), OK-432 (n = 12, 14%), and others (n = 2, 2%). No difference existed in the number of days from initial pleurodesis to chest tube removal among the three groups (talc, 3 days; autologous blood patch, 3 days; OK-432, 2 days; P = 0.55). No difference in patient background, except for sex, was observed between patients who underwent pleurodesis within 4 PODs and those who underwent pleurodesis on POD 5 or later. Drainage time was significantly shorter in patients who underwent pleurodesis within 4 PODs (median, 7 vs. 9 days; P = 0.004).

Conclusions: The efficacies of autologous blood patch, talc, and OK-432 would be considered comparable and early postoperative pleurodesis could shorten drainage time. Prospective studies are required.

Keywords: Lung cancer; Pleurodesis; Postoperative air leakage.

MeSH terms

  • Carcinoma, Non-Small-Cell Lung* / surgery
  • Humans
  • Lung
  • Lung Neoplasms* / surgery
  • Picibanil
  • Pleurodesis / methods
  • Pneumonectomy / adverse effects
  • Pneumonectomy / methods
  • Retrospective Studies
  • Talc

Substances

  • Talc
  • Picibanil