Prolonged air leak after segmentectomy: incidence and risk factors.

Abstract

We designed this study to investigate the rate and risk factors of prolonged air leak (PAL) in patients undergoing pulmonary segmentectomy in our unit. We performed a retrospective cohort study on 191 patients undergoing pulmonary segmentectomy (January 2017-August 2021). A PAL was defined as an air leak >5 days. One hundred and sixty-eight segmentectomies were performed using video-assisted thoracoscopic surgery (VATS), 13 were open operations and 10 were robotic. PAL occurred in 36 patients (19%). Their average post-operative stay was 2.4 days longer than those without PAL. Logistic regression analysis showed that a low preoperative carbon monoxide lung diffusion capacity (DLCO) (OR 0.98, P<0.001), low body mass index (BMI) (OR 0.95, P=0.002) and the performance of complex segmentectomies (OR 2.2, P<0.001). were significantly associated with PAL. Pulmonary segmentectomies are associated with a not negligible risk of PAL when using real world data, especially in patients with compromised pulmonary function and after complex segmentectomies. This finding is useful to inform the decision-making process.