Predicting prolonged air leak after standard pulmonary lobectomy

Computed tomography assessment and risk factors stratification

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background: Prolonged air leak after pulmonary lobectomy is a common time- and cost-consuming complication. Its prevention may significantly reduce hospitalization length and costs offering patients a standard uneventful postoperative course. The aim of the present study is to identify predictors of prolonged postoperative air leak and to stratify preoperative risk factors. Methods: From July 2004 to December 2007 241 consecutive standard lobectomies were performed with curative intent for lung cancer. After excluding patients not fulfilling the inclusion criterion, 58 patients were enrolled in the "prolonged air leak" group and 63 patients were enrolled in the "standard outcome" group. Results: Total lung capacity (p= 0.0038) and percentage emphysema (p= 0.0050) calculated by computed tomography were both significantly related to prolonged postoperative air leak; the values of 4773 cc and 0.4% showed the highest predictive value in terms of sensitivity (84.5% and 75.9% respectively). Multivariate logistic regression disclosed that male sex (p= 0.0006), right side of operation (p= 0.0010) and age (p= 0.0082) were significantly related to prolonged postoperative air leak. Preoperative chemotherapy (p= 0.0940) did not affect air leak status. Conclusions: Computed tomography quantification of emphysema is the best predictor of prolonged air leak. Age, male sex and right side lobectomy are correlated to this complication. Preoperative chemotherapy is not an additional risk factor.

Original languageEnglish
Pages (from-to)72-77
Number of pages6
JournalSurgeon
Volume9
Issue number2
DOIs
Publication statusPublished - Apr 2011

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Air
Tomography
Lung
Emphysema
Total Lung Capacity
Costs and Cost Analysis
Drug Therapy
Lung Neoplasms
Hospitalization
Logistic Models

Keywords

  • Air leak
  • Computed tomography
  • Emphysema
  • Lobectomy

ASJC Scopus subject areas

  • Surgery

Cite this

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abstract = "Background: Prolonged air leak after pulmonary lobectomy is a common time- and cost-consuming complication. Its prevention may significantly reduce hospitalization length and costs offering patients a standard uneventful postoperative course. The aim of the present study is to identify predictors of prolonged postoperative air leak and to stratify preoperative risk factors. Methods: From July 2004 to December 2007 241 consecutive standard lobectomies were performed with curative intent for lung cancer. After excluding patients not fulfilling the inclusion criterion, 58 patients were enrolled in the {"}prolonged air leak{"} group and 63 patients were enrolled in the {"}standard outcome{"} group. Results: Total lung capacity (p= 0.0038) and percentage emphysema (p= 0.0050) calculated by computed tomography were both significantly related to prolonged postoperative air leak; the values of 4773 cc and 0.4{\%} showed the highest predictive value in terms of sensitivity (84.5{\%} and 75.9{\%} respectively). Multivariate logistic regression disclosed that male sex (p= 0.0006), right side of operation (p= 0.0010) and age (p= 0.0082) were significantly related to prolonged postoperative air leak. Preoperative chemotherapy (p= 0.0940) did not affect air leak status. Conclusions: Computed tomography quantification of emphysema is the best predictor of prolonged air leak. Age, male sex and right side lobectomy are correlated to this complication. Preoperative chemotherapy is not an additional risk factor.",
keywords = "Air leak, Computed tomography, Emphysema, Lobectomy",
author = "Francesco Petrella and Stefania Rizzo and Davide Radice and Alessandro Borri and Domenico Galetta and Roberto Gasparri and Piergiorgio Solli and Giulia Veronesi and Massimo Bellomi and Lorenzo Spaggiari",
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T1 - Predicting prolonged air leak after standard pulmonary lobectomy

T2 - Computed tomography assessment and risk factors stratification

AU - Petrella, Francesco

AU - Rizzo, Stefania

AU - Radice, Davide

AU - Borri, Alessandro

AU - Galetta, Domenico

AU - Gasparri, Roberto

AU - Solli, Piergiorgio

AU - Veronesi, Giulia

AU - Bellomi, Massimo

AU - Spaggiari, Lorenzo

PY - 2011/4

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N2 - Background: Prolonged air leak after pulmonary lobectomy is a common time- and cost-consuming complication. Its prevention may significantly reduce hospitalization length and costs offering patients a standard uneventful postoperative course. The aim of the present study is to identify predictors of prolonged postoperative air leak and to stratify preoperative risk factors. Methods: From July 2004 to December 2007 241 consecutive standard lobectomies were performed with curative intent for lung cancer. After excluding patients not fulfilling the inclusion criterion, 58 patients were enrolled in the "prolonged air leak" group and 63 patients were enrolled in the "standard outcome" group. Results: Total lung capacity (p= 0.0038) and percentage emphysema (p= 0.0050) calculated by computed tomography were both significantly related to prolonged postoperative air leak; the values of 4773 cc and 0.4% showed the highest predictive value in terms of sensitivity (84.5% and 75.9% respectively). Multivariate logistic regression disclosed that male sex (p= 0.0006), right side of operation (p= 0.0010) and age (p= 0.0082) were significantly related to prolonged postoperative air leak. Preoperative chemotherapy (p= 0.0940) did not affect air leak status. Conclusions: Computed tomography quantification of emphysema is the best predictor of prolonged air leak. Age, male sex and right side lobectomy are correlated to this complication. Preoperative chemotherapy is not an additional risk factor.

AB - Background: Prolonged air leak after pulmonary lobectomy is a common time- and cost-consuming complication. Its prevention may significantly reduce hospitalization length and costs offering patients a standard uneventful postoperative course. The aim of the present study is to identify predictors of prolonged postoperative air leak and to stratify preoperative risk factors. Methods: From July 2004 to December 2007 241 consecutive standard lobectomies were performed with curative intent for lung cancer. After excluding patients not fulfilling the inclusion criterion, 58 patients were enrolled in the "prolonged air leak" group and 63 patients were enrolled in the "standard outcome" group. Results: Total lung capacity (p= 0.0038) and percentage emphysema (p= 0.0050) calculated by computed tomography were both significantly related to prolonged postoperative air leak; the values of 4773 cc and 0.4% showed the highest predictive value in terms of sensitivity (84.5% and 75.9% respectively). Multivariate logistic regression disclosed that male sex (p= 0.0006), right side of operation (p= 0.0010) and age (p= 0.0082) were significantly related to prolonged postoperative air leak. Preoperative chemotherapy (p= 0.0940) did not affect air leak status. Conclusions: Computed tomography quantification of emphysema is the best predictor of prolonged air leak. Age, male sex and right side lobectomy are correlated to this complication. Preoperative chemotherapy is not an additional risk factor.

KW - Air leak

KW - Computed tomography

KW - Emphysema

KW - Lobectomy

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