Articles Vol. 65 No. CĐ 3 - Bệnh viện Phổi Trung ương 15/05/2024

40. MANAGEMENT OF PERSISTENT AIR LEAK AFTER THORACOSCOPIC LOBECTOMY FOR NON-SMALL CELL LUNG CANCER AT THE NATIONAL LUNG HOSPITAL: PREDICTION, PREVENTION AND TREATMENT

Pham Thi Thanh Dua1,2, Nguyen Si Khanh1,2, Nguyen Quoc Tuan1,2, Dinh Van Luong1,2
1 National Lung Hospital
2 Bệnh viện Phổi Trung ương
Corresponding author: phamdua7587@gmail.com
DOI: 10.52163/yhc.v65iCD3.1137
13 Views
10 Downloads
Keywords
Prolonged air leak (PAL).
Abstract

Background: Prolonged air leak (PAL) after thoracoscopic lobectomy for non-small cell cancer (VATS) is a common complication. We explored pre-intervention prognostic risk factors and evaluated whether quantitative measurement of intraoperative air leak using mechanical ventilation testing can predict, prevention, management PAL and identify patients requiring additional treatment.

Methods: 84 patients underwent thoracoscopic cancer lobectomy (VATS) from April 2023 - December 2023 at the National Lung Hospital. Research by descriptive and retrospective method.

Results: At the end of the lobectomy, the remaining lung lobe was immersed in re-inflated ventilation water with a pressure of 25-30 cmH2O to evaluate the air leak situation, and have a treatment strategy to limit the PAL condition. prolongation after surgery and post-operative management directions.

Conclusion: Preoperative and intraoperative risk factors using mechanical ventilation test help evaluate PAL after VATS lobectomy, thereby providing appropriate intraoperative and postoperative management for patients to withdraw drainage and discharge early, limiting possible complications when draining the pleural space for a long time in patients.

References
[1]
Brunelli A, Varela G, Refai M et al., A scoring Google Scholar
[2]
system to predict the risk of prolonged air leak Google Scholar
[3]
after lobectomy. Ann Thorac Surg 2010;90:204- Google Scholar
[4]
10.1016 Google Scholar
[5]
Rivera C, Bernard A, Falcoz PE et al., Characterization Google Scholar
[6]
and prediction of prolonged air leak after Google Scholar
[7]
pulmonary resection: A nationwide study setting Google Scholar
[8]
up the index of prolonged air leak. Ann Thorac Google Scholar
[9]
Surg 2011;92:1062-8. 10.1016 Google Scholar
[10]
Adam Attaar, MD, Vernissia Tam, MD et al., Google Scholar
[11]
Risk Factors for Prolonged Air Leak After Google Scholar
[12]
Pulmonary Resection A Systematic Review Google Scholar
[13]
and Meta-Analysis. 2019 Wolters Kluwer Google Scholar
[14]
Health, Inc. All rights reserved. DOI: 10.1097/ Google Scholar
[15]
SLA.0000000000003560. Google Scholar
[16]
Igai H, Kamiyoshihara M, Numajiri K et al., Google Scholar
[17]
Procedures to avoid postoperative prolonged Google Scholar
[18]
air leak in thoracic surgery. J Thorac Dis Google Scholar
[19]
;14(11):4220-4222. doi:10.21037/jtd-22- Google Scholar
[20]
Francesco Zaraca1, Roberto Crisci2, Florian Augustin3 et al., Google Scholar
[21]
Prolonged air leak after lung surgery: Prediction, Google Scholar
[22]
prevention and management. journal of Thoracic Disease Google Scholar
[23]
;15(2):835-838 Google Scholar
[24]
Messina G, Natale G, Bove M et al., Intraoperative Google Scholar
[25]
ventilatory leak: Real-time guidance for Google Scholar
[26]
management of air leak in lung cancer patients Google Scholar
[27]
undergoing VATS lobectomy. Thorac Cancer. Google Scholar
[28]
;14(18):1782–8. Google Scholar