P3.04-030 Examination of the Relevance of Prolonged Air Leakage after Pulmonary Resection for Lung Cancer and Factors Affecting Delayed Wound Healing: Topic: Miscellaneous II

Abstract

The management of prolonged air leakage (PAL), a common complication that occurs in 8% to 26% of patients undergoing pulmonary resection, is difficult in many cases, and is also associated with other complications. Blood coagulation factor XIII (BCFXIII) is known to play a role in wound healing. However, little is known about the role of BCFXIII in the field of thoracic surgery. We examined the association between BCFXIII and PAL, chronic obstructive pulmonary disease (COPD) and PAL, and total protein (TP; an index of nutrition) and PAL. This study included 43 patients with primary lung cancer who underwent pulmonary resection in our institution and developed air leakage for at least 3 days postoperatively. All patients agreed to measurement of their plasma BCFXIII levels. BCFXIII, TP, and pulmonary function were measured within 1 month preoperatively. TP and BCFXIII were measured 5 days after surgery. The t-test was used for statistical analysis. The mean duration of drainage was 6.3±3.2 days in patients with a postoperative BCFXIII level of >70% and 8.8±4.2 days in those with a postoperative BCFXIII level of ≤70%. Patients with postoperative BCFXIII ≤70% (n=11) required drain placement for a significantly longer period (p=0.049). The mean duration of drainage was 6.3±3.2 days in patients with forced expiratory volume 1.0% (FEV1.0%) ≥70% and 8.8±4.0 days in those with FEV1.0% <70% (n=11). Patients with FEV1.0% <70% required drain placement for a significantly longer period (p=0.038). Our analysis did not find a significant difference in the duration of drainage in relation to nutritional status in groups with postoperative TP ≥6.6 g/dl and <6.6 g/dl (n=35). However, the postoperative BCFXIII levels were significantly lower in patients with low postoperative TP levels (BCFXIII 79±16%) than in those with normal postoperative TP levels (BCFXIII: 96±23%) (p=0.033). Our results suggest that low BCFXIII levels may be associated with PAL. Moreover, we found COPD to be closely related to PAL. No significant difference was noted in the duration of drainage between normal and low-nutrition patients. However, poor nutrition may have an effect on PAL as a result of decreased BCFXIII level.