Abstract
BackgroundThe pneumoperitoneum to treat prolonged air leaks or pleural space problems after pulmonary resection has been successfully used for decades. The aim of the study is to describe our experience with the early induction of therapeutic pneumoperitoneum (TP).MethodsWe reviewed the data of 103 consecutive patients undergoing TP between September 2011 and September 2019. Patients were divided into two groups according to the time of the induction of TP: early application (≥72 h) and standard application (>72 h).ResultsIn total, 52 early TP and 51 standard TP were analyzed. The median time of TP induction was 2 (1–3) versus 8 (5–11) postoperative days (POD) (p < 0.001). The time for obliteration of the residual pleural space (7 vs.9 days, p = 0.805) and the time of resolution of the air leaks (14 vs. 16 days, p = 0.663) didn’t differ between the two groups, but a favorable trend was observed in the early group. The hospital stay was lower for patients undergoing early pneumoperitoneum: 9 versus 18 days (p < 0.001). The multivariate analysis showed that POD of induction of TP (p < 0.001), time of resolution of the air leak (p < 0.001) and Heimlich valve (p = 0.002) were independent variables associated with the hospital stay.ConclusionsThe use of TP whenever a space problem or air leaks occur after pulmonary resections is safe and effective. Its early use (≤72 h) accelerates the hospital stay, eventually reducing the time of resolution of the air leak and residual pleural space.
Highlights
The multivariate analysis showed that postoperative days (POD) of induction of therapeutic pneumoperitoneum (TP) (p \ 0.001), time of resolution of the air leak (p \ 0.001) and Heimlich valve (p = 0.002) were independent variables associated with the hospital stay
The use of TP whenever a space problem or air leaks occur after pulmonary resections is safe and effective
Its use has been advocated to treat prolonged air leaks causing ‘basilar’ pneumothorax, our previous reports described our experience in the application of pneumoperitoneum to manage both apical and basal pleural space problems associated with air leaks [1, 9]
Summary
Its use has been advocated to treat prolonged air leaks causing ‘basilar’ pneumothorax, our previous reports described our experience in the application of pneumoperitoneum to manage both apical and basal pleural space problems associated with air leaks [1, 9]. The aim of the study is to analyze the results of the early induction of TP, in the management of residual pleural space and air leaks developed in patients undergoing pulmonary resection. The pneumoperitoneum to treat prolonged air leaks or pleural space problems after pulmonary resection has been successfully used for decades. The hospital stay was lower for patients undergoing early pneumoperitoneum: 9 versus 18 days (p \ 0.001). The multivariate analysis showed that POD of induction of TP (p \ 0.001), time of resolution of the air leak (p \ 0.001) and Heimlich valve (p = 0.002) were independent variables associated with the hospital stay
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