Display options
Cite
Hoeijmakers F, Hartemink KJ, Verhagen AF, et al. Variation in incidence, prevention and treatment of persistent air leak after lung cancer surgery. Eur J Cardiothorac Surg. 2021;61(1):110-117doi: 10.1093/ejcts/ezab376.
Hoeijmakers, F., Hartemink, K. J., Verhagen, A. F., Steup, W. H., Marra, E., Röell, W. F. B., Heineman, D. J., Schreurs, W. H., Tollenaar, R. A. E. M., & Wouters, M. W. J. M. (2021). Variation in incidence, prevention and treatment of persistent air leak after lung cancer surgery. European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 61(1), 110-117. https://doi.org/10.1093/ejcts/ezab376
Hoeijmakers, Fieke, et al. "Variation in incidence, prevention and treatment of persistent air leak after lung cancer surgery." European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery vol. 61,1 (2021): 110-117. doi: https://doi.org/10.1093/ejcts/ezab376
Hoeijmakers F, Hartemink KJ, Verhagen AF, Steup WH, Marra E, Röell WFB, Heineman DJ, Schreurs WH, Tollenaar RAEM, Wouters MWJM. Variation in incidence, prevention and treatment of persistent air leak after lung cancer surgery. Eur J Cardiothorac Surg. 2021 Dec 27;61(1):110-117. doi: 10.1093/ejcts/ezab376. PMID: 34410339.
Copy Download .nbib Format: NLM
Share it on

Eur J Cardiothorac Surg. 2021 Dec 27;61(1):110-117. doi: 10.1093/ejcts/ezab376.

Variation in incidence, prevention and treatment of persistent air leak after lung cancer surgery.

European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery

Fieke Hoeijmakers, Koen J Hartemink, Ad F Verhagen, Willem H Steup, Elske Marra, W F Boudewijn Röell, David J Heineman, Wilhelmina H Schreurs, Rob A E M Tollenaar, Michel W J M Wouters

Affiliations

  1. Department of Surgery, Leiden University Medical Center, Leiden, Netherlands.
  2. Scientific Bureau, Dutch Institute for Clinical Auditing, Leiden, Netherlands.
  3. Department of Surgical Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands.
  4. Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, Netherlands.
  5. Department of Surgery, HAGA Hospital, Den Haag, Netherlands.
  6. Faculty of Medicine, Leiden University, Leiden, Netherlands.
  7. Department of Surgery, Amsterdam UMC, VU University Medical Center, Amsterdam, Netherlands.
  8. Department of Cardiothoracic Surgery, Amsterdam UMC, VU University Medical Center, Amsterdam, Netherlands.
  9. Department of Surgery, Northwest Clinics, Alkmaar, Netherlands.

PMID: 34410339 DOI: 10.1093/ejcts/ezab376

Abstract

OBJECTIVES: Persistent air leak (PAL; >5 days after surgery) is the most common complication after pulmonary resection and associated with prolonged hospital stay and increased morbidity. Literature is contradictory about the prevention and treatment of PAL. Variation is therefore hypothesized. The aim of this study is to understand the variation in the incidence, preventive management and treatment of PAL.

METHODS: Data from the Dutch Lung Cancer Audit for Surgery were combined with results of an online survey among Dutch thoracic surgeons. The national incidence of PAL and case-mix corrected between-hospital variation were calculated in patients who underwent an oncological (bi)lobectomy or segmentectomy between January 2012 and December 2018. By multivariable logistic regression, factors associated with PAL were assessed. A survey was designed to assess variation in (preventive) management and analysed using descriptive statistics. Hospital-level associations between management strategies and PAL were assessed by univariable linear regression.

RESULTS: Of 12 382 included patients, 9.0% had PAL, with a between-hospital range of 2.6-19.3%. Factors associated with PAL were male sex, poor lung function, low body mass index, high American Society of Anesthesiologists (ASA) score, pulmonary comorbidity, upper lobe resection, (bi)lobectomy (vs segmentectomy), right-sided tumour and robotic-assisted thoracic surgery. Perioperative (preventive) management of PAL differed widely between hospitals. When using water seal compared to suction drainage, the average incidence of PAL decreased 2.9%.

CONCLUSIONS: In the Netherlands, incidence and perioperative (preventive) management of PAL vary widely. Using water seal instead of suction drainage and increasing awareness are potential measures to reduce this variation.

© The Author(s) 2021. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.

Keywords: Lung cancer; Persistent air leak; Prevention; Prolonged air leak; Treatment

Publication Types