Prolonged air leak (PAL) is one of the most common complication in patients underwent pulmonary resection. The prevention and treatment of PAL are important for the quick recovery of these patients. In this review, we summarized systematically four aspects of PAL including the clinical definition of PAL and influence factors, common risk factors and prediction model, prevention and perioperative management, and postoperative treatment.
Citation： LIHua-sheng, MEIJian-dong, ZHAOKe-jiang, LIULun-xu. Present Situation and Progression of Prolonged Air Leak after Pulmonary Resection. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(8): 832-835. doi: 10.7507/1007-4848.20160198 Copy
| 1. | Bm H, Rw A. Prolonged air leak after lung resection. Current Respiratory Medicine Reviews, 2012, 8(4):280-284. |
| 2. | Jeon H W, Kim Y D, Kye Y K, et al. Air leakage on the postoperative day:powerful factor of postoperative recurrence after thoracoscopic bullectomy. J Thorac Dis, 2016, 8(1):93-97. |
| 3. | Brunelli A, Xiume F, Al Refai M, et al. Air leaks after lobectomy increase the risk of empyema but not of cardiopulmonary complica-tions:a case-matched analysis. Chest, 2006, 130(4):1150-1156. |
| 4. | Okereke I, Murthy S C, Alster J M, et al. Characterization and importance of air leak after lobectomy. Ann Thorac Surg, 2005, 79 (4):1167-1173. |
| 5. | Varela G, Jimenez M F, Novoa N, et al. Estimating hospital costs attributable to prolonged air leak in pulmonary lobectomy. Eur J Cardiothorac Surg, 2005, 27(2):329-333. |
| 6. | Boffa D J, Allen M S, Grab J D, et al. Data from The Society of Thoracic Surgeons General Thoracic Surgery database:the surgical management of primary lung tumors. J Thorac Cardiovasc Surg, 2008, 135(2):247-254. |
| 7. | Brunelli A, Cassivi S D, Halgren L. Risk factors for prolonged air leak after pulmonary resection. Thorac Surg Clin, 2010, 20(3):359-364. |
| 8. | Ciccone A M, Meyers B F, Guthrie T J, et al. Long-term outcome of bilateral lung volume reduction in 250 consecutive patients with emphysema. J Thorac Cardiovasc Surg, 2003, 125(3):513-525. |
| 9. | Rodriguez M, Jimenez M F, Hernandez M T, et al. Usefulness of conventional pleural drainage systems to predict the occurrence of prolonged air leak after anatomical pulmonary resection. Eur J Cardiothorac Surg, 2015, 48(4):612-615. |
| 10. | 杜开齐, 朱有才, 张志豪, 等.肺部手术后迁延性肺漏气104例.武警医学, 2009, 20(11):1039-1040. |
| 11. | 吴瑞锋, 梁景芳, 刘金山, 等.电视胸腔镜术后肺持续漏气原因分析与处理.中国综合临床, 2012, 28(3):321-322. |
| 12. | 杨利红, 徐旋里, 周建英.老年肺癌手术并发症及相关因素.中国老年学杂志, 2015, (12):3320-3322. |
| 13. | Brunelli A, Varela G, Refai M, et al. A scoring system to predict the risk of prolonged air leak after lobectomy. Ann Thorac Surg, 2010, 90(1):204-9. |
| 14. | Rivera C, Bernard A, Falcoz P E, et al. Characterization and predic-tion of prolonged air leak after pulmonary resection:a nationwide study setting up the index of prolonged air leak. Ann Thorac Surg, 2011, 92(3):1062-1068. |
| 15. | Orsini B, Baste J M, Gossot D, et al. Index of prolonged air leak score validation in case of video-assisted thoracoscopic surgery anatomical lung resection:results of a nationwide study based on the French national thoracic database, EPITHOR. Eur J Cardiothorac Surg, 2015, 48(4):608-611. |
| 16. | Venuta F, Rendina E A, De Giacomo T, et al. Postoperative strate-gies to treat permanent air leaks. Thorac Surg Clin, 2010, 20(3):391-7. |
| 17. | 陈沁华. 28例全胸腔镜下肺癌根治术患者的护理.全科护理, 2013, 11(11):2931-2932. |
| 18. | 王天佑.胸外科围手术期肺保护的专家共识.中华外科杂志, 2009, 47(18):1361-1364. |
| 19. | 吴芳, 马翠英, 潘旭玲.呼吸功能锻炼在肺减容术后持续肺漏气患者中的应用.中外健康文摘, 2014, 8:59-60. |
| 20. | 曾先文, 胡朝阳, 景其强, 等.胸腔镜手术与传统开胸手术治疗胸部疾病的效果对比观察.医学理论与实践, 2014, (13):1724-1725. |
| 21. | 陈海兵, 朱全, 陈亮.连续231例全电视胸腔镜肺叶切除术治疗非小细胞肺癌近、远期疗效分析.中国胸心血管外科临床杂志, 2013, 20(6):673-678. |
| 22. | 潘相龙, 陈亮, 朱全. 103例全胸腔镜解剖性肺段切除近期疗效分析.南京医科大学学报:自然科学版, 2014, 34(6):800-804. |
| 23. | Stamenovic D, Bostanci K, Messerschmidt A, et al. Fissureless fissure-last video-assisted thoracoscopic lobectomy for all lung lobes:a better alternative to decrease the incidence of prolonged air leak? dagger. Eur J Cardiothorac Surg, 2016, Jan 19. pii:ezv455.[Epub ahead of print]. |
| 24. | 谭群友, 邓波, 康珀铭, 等. 276例单操作孔全胸腔镜肺叶切除治疗早期非小细胞肺癌的围术期效果分析.第三军医大学学报, 2012, 34(21):2181-2183. |
| 25. | 张勇, 陆善伟, 王明松.单操作孔胸腔镜技术治疗早期肺癌.实用医学杂志, 2015, (18):3066-3068. |
| 26. | Tacconi F, Pompeo E, Mineo T C. Duration of air leak is reduced after awake nonresectional lung volume reduction surgery. Eur J Cardiothorac Surg, 2009, 35(5):822-828. |
| 27. | Okur E, Arisoy Y, Baysungur V, et al. Prophylactic intraoperative pneumoperitoneum decreases pleural space problems after lower lobectomy or bilobectomy of the lung. Thorac Cardiovasc Surg, 2009, 57(3):160-164. |
| 28. | Toker A, Dilege S, Tanju S, et al. Perioperative pneumoperitoneum after lobectomy——bilobectomy operations for lung cancer:a pros-pective study. Thorac Cardiovasc Surg, 2003, 51(2):93-96. |
| 29. | 胡欣春, 邬海, 程吕欢, 等.聚乙醇酸网状材料在自发性气胸外科治疗中的临床研究.实用中西医结合临床, 2012, 12(2):29-30. |
| 30. | 杨海平, 吴骏, 孙林, 等.奈维在胸腔镜肺大泡切除术后防止漏气的临床疗效.中国综合临床, 2011, 27(4):440-442. |
| 31. | Ikeda T, Sasaki M, Yamada N, et al. Controlling air leaks using free pericardial fat pads as surgical sealant in pulmonary resection. Ann Thorac Surg, 2015, 99(4):1170-1175. |
| 32. | Gonfiotti A, Santini P F, Jaus M, et al. Safety and effectiveness of a new fibrin pleural air leak sealant:a multicenter, controlled, prospective, parallel-group, randomized clinical trial. Ann Thorac Surg, 2011, 92(4):1217-1225. |
| 33. | Lopez C, Facciolo F, Lequaglie C, et al. Efficacy and safety of fibrin sealant patch in the treatment of air leakage in thoracic surgery. Minerva Chir, 2013, 68(6):559-567. |
| 34. | Korasidis S, Andreetti C, D'andrilli A, et al. Management of residual pleural space and air leaks after major pulmonary resection. Interact Cardiovasc Thorac Surg, 2010, 10(6):923-925. |
| 35. | Uzzaman MM, Daniel Robb J, Mhandu PC, et al. A meta-analysis assessing the benefits of concomitant pleural tent procedure after upper lobectomy. Ann Thorac Surg, 2014, 97(1):365-372. |
| 36. | Mueller MR, Marzluf BA. The anticipation and management of air leaks and residual spaces post lung resection. J Thorac Dis, 2014, 6(3):271-284. |
| 37. | Anegg U, Lindenmann J, Matzi V, et al. AIRFIX:the first digital postoperative chest tube airflowmetry——a novel method to quantify air leakage after lung resection. Eur J Cardiothorac Surg, 2006, 29(6):867-872. |
| 38. | Cerfolio RJ, Bryant AS. The benefits of continuous and digital air leak assessment after elective pulmonary resection:a prospective study. Ann Thorac Surg, 2008, 86(2):396-401. |
| 39. | Rathinam S, Bradley A, Cantlin T, et al. Thopaz Portable Suction Systems in Thoracic Surgery:an end user assessment and feedback in a tertiary unit. J Cardiothorac Surg, 2011, 6:59. |
| 40. | Royer A M, Smith J S, Miller A, et al. Safety of Outpatient chest tube management of air leaks after pulmonary resection. Am Surg, 2015, 81(8):760-763. |
| 41. | Lang P, Manickavasagar M, Burdett C, et al. Suction on chest drains following lung resection:evidence and practice are not aligned. Eur J Cardiothorac Surg, 2016, 49(2):611-616. |
| 42. | Leo F, Duranti L, Girelli L, et al. Does external pleural suction reduce prolonged air leak after lung resection? Results from the AirINTrial after 500 randomized cases. Ann Thorac Surg, 2013, 96(4):1234-1239. |
| 43. | 赵永生, 刘伦旭.肺叶切除术后胸腔引流的管理.中国胸心血管外科临床杂志, 2013, 20(3):338-342. |
| 44. | 刘琼, 肖力.胸腔注射高渗糖水治疗胸部手术后肺持续漏气的护理.护士进修杂志, 2015, 30(22):2098-2099. |
| 45. | 张辉, 张淼, 胡正群, 等.甘露聚糖肽胸腔灌注治疗持续性肺漏气.中国实用乡村医生杂志, 2015, 22(10):38-39. |
| 46. | 丁君蓉, 鲁敏, 史苏霞.自体血治疗肺叶切除术后持续漏气的护理.上海护理, 2011, 11(1):34-35. |
| 47. | Carr JA. The intracorporeal use of 2-octyl cyanoacrylate resin to control air leaks after lung resection. Eur J Cardiothorac Surg, 2011, 39(4):579-583. |
| 48. | 赵永生, 马林, 刘伦旭.白介素-2在肺切除术后持续性肺漏气治疗中的应用.华西医学, 2013, 28(4):571-572. |
| 49. | 刘鹏, 蒋占鑫, 席俊峰.鸦胆子油在肺癌术后肺漏气及引流液增多治疗中的作用.延安大学学报(医学科学版), 2014, 12(3):19-21. |
| 50. | Dooms CA, De Leyn PR, Yserbyt J, et al. Endobronchial valves for persistent postoperative pulmonary air leak:accurate monitoring and functional implications. Respiration, 2012, 84(4):329-33. |
| 51. | Dooms CA, Decaluwe H, Yserbyt J, et al. Bronchial valve treatment for pulmonary air leak after anatomical lung resection for cancer. Eur Respir J, 2014, 43(4):1142-1148. |
| 52. | Travaline JM, Mckenna RJ, Jr, De Giacomo T, et al. Treatment of persistent pulmonary air leaks using endobronchial valves. Chest, 2009, 136(2):355-360. |
| 53. | 魏建强, 聂文军, 冯君.自体血胸腔内注入治疗不能耐受手术患者持续肺漏气.中国基层医药, 2014, (20):3183-3184. |
| 54. | Lillegard J B, Kennedy R D, Ishitani M B, et al. Autologous blood patch for persistent air leak in children. J Pediatr Surg, 2013, 48(9):1862-1866. |
| 55. | Karangelis D, Tagarakis G I, Daskalopoulos M, et al. Intrapleural instillation of autologous blood for persistent air leak in spontan-eous pneumothorax-is it as effective as it is safe? J Cardiothorac Surg, 2010, 5:61. doi:10.1186/1749-8090-5-61. |
| 56. | De Giacomo T, Rendina EA, Venuta F, et al. Pneumoperitoneum for the management of pleural air space problems associated with major pulmonary resections. Ann Thorac Surg, 2001, 72(5):1716-1719. |
- 1. Bm H, Rw A. Prolonged air leak after lung resection. Current Respiratory Medicine Reviews, 2012, 8(4):280-284.
- 2. Jeon H W, Kim Y D, Kye Y K, et al. Air leakage on the postoperative day:powerful factor of postoperative recurrence after thoracoscopic bullectomy. J Thorac Dis, 2016, 8(1):93-97.
- 3. Brunelli A, Xiume F, Al Refai M, et al. Air leaks after lobectomy increase the risk of empyema but not of cardiopulmonary complica-tions:a case-matched analysis. Chest, 2006, 130(4):1150-1156.
- 4. Okereke I, Murthy S C, Alster J M, et al. Characterization and importance of air leak after lobectomy. Ann Thorac Surg, 2005, 79 (4):1167-1173.
- 5. Varela G, Jimenez M F, Novoa N, et al. Estimating hospital costs attributable to prolonged air leak in pulmonary lobectomy. Eur J Cardiothorac Surg, 2005, 27(2):329-333.
- 6. Boffa D J, Allen M S, Grab J D, et al. Data from The Society of Thoracic Surgeons General Thoracic Surgery database:the surgical management of primary lung tumors. J Thorac Cardiovasc Surg, 2008, 135(2):247-254.
- 7. Brunelli A, Cassivi S D, Halgren L. Risk factors for prolonged air leak after pulmonary resection. Thorac Surg Clin, 2010, 20(3):359-364.
- 8. Ciccone A M, Meyers B F, Guthrie T J, et al. Long-term outcome of bilateral lung volume reduction in 250 consecutive patients with emphysema. J Thorac Cardiovasc Surg, 2003, 125(3):513-525.
- 9. Rodriguez M, Jimenez M F, Hernandez M T, et al. Usefulness of conventional pleural drainage systems to predict the occurrence of prolonged air leak after anatomical pulmonary resection. Eur J Cardiothorac Surg, 2015, 48(4):612-615.
- 10. 杜开齐, 朱有才, 张志豪, 等.肺部手术后迁延性肺漏气104例.武警医学, 2009, 20(11):1039-1040.
- 11. 吴瑞锋, 梁景芳, 刘金山, 等.电视胸腔镜术后肺持续漏气原因分析与处理.中国综合临床, 2012, 28(3):321-322.
- 12. 杨利红, 徐旋里, 周建英.老年肺癌手术并发症及相关因素.中国老年学杂志, 2015, (12):3320-3322.
- 13. Brunelli A, Varela G, Refai M, et al. A scoring system to predict the risk of prolonged air leak after lobectomy. Ann Thorac Surg, 2010, 90(1):204-9.
- 14. Rivera C, Bernard A, Falcoz P E, et al. Characterization and predic-tion of prolonged air leak after pulmonary resection:a nationwide study setting up the index of prolonged air leak. Ann Thorac Surg, 2011, 92(3):1062-1068.
- 15. Orsini B, Baste J M, Gossot D, et al. Index of prolonged air leak score validation in case of video-assisted thoracoscopic surgery anatomical lung resection:results of a nationwide study based on the French national thoracic database, EPITHOR. Eur J Cardiothorac Surg, 2015, 48(4):608-611.
- 16. Venuta F, Rendina E A, De Giacomo T, et al. Postoperative strate-gies to treat permanent air leaks. Thorac Surg Clin, 2010, 20(3):391-7.
- 17. 陈沁华. 28例全胸腔镜下肺癌根治术患者的护理.全科护理, 2013, 11(11):2931-2932.
- 18. 王天佑.胸外科围手术期肺保护的专家共识.中华外科杂志, 2009, 47(18):1361-1364.
- 19. 吴芳, 马翠英, 潘旭玲.呼吸功能锻炼在肺减容术后持续肺漏气患者中的应用.中外健康文摘, 2014, 8:59-60.
- 20. 曾先文, 胡朝阳, 景其强, 等.胸腔镜手术与传统开胸手术治疗胸部疾病的效果对比观察.医学理论与实践, 2014, (13):1724-1725.
- 21. 陈海兵, 朱全, 陈亮.连续231例全电视胸腔镜肺叶切除术治疗非小细胞肺癌近、远期疗效分析.中国胸心血管外科临床杂志, 2013, 20(6):673-678.
- 22. 潘相龙, 陈亮, 朱全. 103例全胸腔镜解剖性肺段切除近期疗效分析.南京医科大学学报:自然科学版, 2014, 34(6):800-804.
- 23. Stamenovic D, Bostanci K, Messerschmidt A, et al. Fissureless fissure-last video-assisted thoracoscopic lobectomy for all lung lobes:a better alternative to decrease the incidence of prolonged air leak? dagger. Eur J Cardiothorac Surg, 2016, Jan 19. pii:ezv455.[Epub ahead of print].
- 24. 谭群友, 邓波, 康珀铭, 等. 276例单操作孔全胸腔镜肺叶切除治疗早期非小细胞肺癌的围术期效果分析.第三军医大学学报, 2012, 34(21):2181-2183.
- 25. 张勇, 陆善伟, 王明松.单操作孔胸腔镜技术治疗早期肺癌.实用医学杂志, 2015, (18):3066-3068.
- 26. Tacconi F, Pompeo E, Mineo T C. Duration of air leak is reduced after awake nonresectional lung volume reduction surgery. Eur J Cardiothorac Surg, 2009, 35(5):822-828.
- 27. Okur E, Arisoy Y, Baysungur V, et al. Prophylactic intraoperative pneumoperitoneum decreases pleural space problems after lower lobectomy or bilobectomy of the lung. Thorac Cardiovasc Surg, 2009, 57(3):160-164.
- 28. Toker A, Dilege S, Tanju S, et al. Perioperative pneumoperitoneum after lobectomy——bilobectomy operations for lung cancer:a pros-pective study. Thorac Cardiovasc Surg, 2003, 51(2):93-96.
- 29. 胡欣春, 邬海, 程吕欢, 等.聚乙醇酸网状材料在自发性气胸外科治疗中的临床研究.实用中西医结合临床, 2012, 12(2):29-30.
- 30. 杨海平, 吴骏, 孙林, 等.奈维在胸腔镜肺大泡切除术后防止漏气的临床疗效.中国综合临床, 2011, 27(4):440-442.
- 31. Ikeda T, Sasaki M, Yamada N, et al. Controlling air leaks using free pericardial fat pads as surgical sealant in pulmonary resection. Ann Thorac Surg, 2015, 99(4):1170-1175.
- 32. Gonfiotti A, Santini P F, Jaus M, et al. Safety and effectiveness of a new fibrin pleural air leak sealant:a multicenter, controlled, prospective, parallel-group, randomized clinical trial. Ann Thorac Surg, 2011, 92(4):1217-1225.
- 33. Lopez C, Facciolo F, Lequaglie C, et al. Efficacy and safety of fibrin sealant patch in the treatment of air leakage in thoracic surgery. Minerva Chir, 2013, 68(6):559-567.
- 34. Korasidis S, Andreetti C, D'andrilli A, et al. Management of residual pleural space and air leaks after major pulmonary resection. Interact Cardiovasc Thorac Surg, 2010, 10(6):923-925.
- 35. Uzzaman MM, Daniel Robb J, Mhandu PC, et al. A meta-analysis assessing the benefits of concomitant pleural tent procedure after upper lobectomy. Ann Thorac Surg, 2014, 97(1):365-372.
- 36. Mueller MR, Marzluf BA. The anticipation and management of air leaks and residual spaces post lung resection. J Thorac Dis, 2014, 6(3):271-284.
- 37. Anegg U, Lindenmann J, Matzi V, et al. AIRFIX:the first digital postoperative chest tube airflowmetry——a novel method to quantify air leakage after lung resection. Eur J Cardiothorac Surg, 2006, 29(6):867-872.
- 38. Cerfolio RJ, Bryant AS. The benefits of continuous and digital air leak assessment after elective pulmonary resection:a prospective study. Ann Thorac Surg, 2008, 86(2):396-401.
- 39. Rathinam S, Bradley A, Cantlin T, et al. Thopaz Portable Suction Systems in Thoracic Surgery:an end user assessment and feedback in a tertiary unit. J Cardiothorac Surg, 2011, 6:59.
- 40. Royer A M, Smith J S, Miller A, et al. Safety of Outpatient chest tube management of air leaks after pulmonary resection. Am Surg, 2015, 81(8):760-763.
- 41. Lang P, Manickavasagar M, Burdett C, et al. Suction on chest drains following lung resection:evidence and practice are not aligned. Eur J Cardiothorac Surg, 2016, 49(2):611-616.
- 42. Leo F, Duranti L, Girelli L, et al. Does external pleural suction reduce prolonged air leak after lung resection? Results from the AirINTrial after 500 randomized cases. Ann Thorac Surg, 2013, 96(4):1234-1239.
- 43. 赵永生, 刘伦旭.肺叶切除术后胸腔引流的管理.中国胸心血管外科临床杂志, 2013, 20(3):338-342.
- 44. 刘琼, 肖力.胸腔注射高渗糖水治疗胸部手术后肺持续漏气的护理.护士进修杂志, 2015, 30(22):2098-2099.
- 45. 张辉, 张淼, 胡正群, 等.甘露聚糖肽胸腔灌注治疗持续性肺漏气.中国实用乡村医生杂志, 2015, 22(10):38-39.
- 46. 丁君蓉, 鲁敏, 史苏霞.自体血治疗肺叶切除术后持续漏气的护理.上海护理, 2011, 11(1):34-35.
- 47. Carr JA. The intracorporeal use of 2-octyl cyanoacrylate resin to control air leaks after lung resection. Eur J Cardiothorac Surg, 2011, 39(4):579-583.
- 48. 赵永生, 马林, 刘伦旭.白介素-2在肺切除术后持续性肺漏气治疗中的应用.华西医学, 2013, 28(4):571-572.
- 49. 刘鹏, 蒋占鑫, 席俊峰.鸦胆子油在肺癌术后肺漏气及引流液增多治疗中的作用.延安大学学报(医学科学版), 2014, 12(3):19-21.
- 50. Dooms CA, De Leyn PR, Yserbyt J, et al. Endobronchial valves for persistent postoperative pulmonary air leak:accurate monitoring and functional implications. Respiration, 2012, 84(4):329-33.
- 51. Dooms CA, Decaluwe H, Yserbyt J, et al. Bronchial valve treatment for pulmonary air leak after anatomical lung resection for cancer. Eur Respir J, 2014, 43(4):1142-1148.
- 52. Travaline JM, Mckenna RJ, Jr, De Giacomo T, et al. Treatment of persistent pulmonary air leaks using endobronchial valves. Chest, 2009, 136(2):355-360.
- 53. 魏建强, 聂文军, 冯君.自体血胸腔内注入治疗不能耐受手术患者持续肺漏气.中国基层医药, 2014, (20):3183-3184.
- 54. Lillegard J B, Kennedy R D, Ishitani M B, et al. Autologous blood patch for persistent air leak in children. J Pediatr Surg, 2013, 48(9):1862-1866.
- 55. Karangelis D, Tagarakis G I, Daskalopoulos M, et al. Intrapleural instillation of autologous blood for persistent air leak in spontan-eous pneumothorax-is it as effective as it is safe? J Cardiothorac Surg, 2010, 5:61. doi:10.1186/1749-8090-5-61.
- 56. De Giacomo T, Rendina EA, Venuta F, et al. Pneumoperitoneum for the management of pleural air space problems associated with major pulmonary resections. Ann Thorac Surg, 2001, 72(5):1716-1719.
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