Prolonged air leak after lobectomy in lung cancer patients

Background. Air-leak after lung resection is a common complication occurring in 30-50 % of patients immediately after surgery. The prolonged air-leak (PAL) is a serious problem if it lasts more than 5 days after lung surgery with the reported incidence of 15 %. Despite the progress in thoracic surgery including energy-based vessel-sealing devices and digital drainage systems, there is no universal agreement on the optimal treatment of patients with prolonged air-leaks. The aim of the study: to improve postoperative outcomes in patients with PAL by optimization of postoperative treatment algorithm. Material and Methods. Treatment outcomes were analyzed in 194 patients, who underwent lobectomy for non-small cell lung cancer in 2017-2018. Results. The prolonged air-leak was detected in 19 (9.8 %) patients after. The average time interval between surgery and development of this complication was 3.4 days. There was no mortality in our series. The median postoperative hospital stay was 8.7 days in patients with non-complicated postoperative period and 14.8 days in patients with PAL. Based on our own experience and practice we have developed and implemented an algorithm of the management of patients with PAL. Conclusion. The treatment of patients with PAL should be based on multidisciplinary approach providing safety of the patients after major lung resection. Each case with PAL should be discussed individually to achieve better results.