Abstract
A contemporary, practical definition of prolonged air leak (PAL) is an air leak that lasts beyond postoperative day 5. This is consistent with the definition used in the Society of Thoracic Surgeons database and represents a leak whose duration exceeds the average length of stay (LOS) for lobectomy. The reported incidence of PAL ranges from 8% to 26% (1), but the definition of PAL has varied amongst reports. PAL increases the LOS, increases hospital costs, and is associated with elevated rates of empyema and other complications. The most consistently reported risk factors for PAL include poor pulmonary function, use of steroids, performance of an upper lobectomy, presence of a pneumothorax coinciding with an air leak, and the presence of pleural adhesions (1,2). With regard to sublobar resection, although it has yet to be studied scientifically, we believe that segmentectomy may have a higher risk of PAL compared to wedge resection due to the increased thickness of some intersegmental planes and the more extensive dissection involved.
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