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The Journal of Cardiovascular Surgery 1999 December;40(6):887-8

language: English

Post­op­er­a­tive pneu­mo­per­i­toneum for pro­longed air ­leaks and ­residual ­spaces ­after pul­mo­nary resec­tions

Carbognani P., Spaggiari L., Solli P. G., Tincani G., Bobbio A., Rusca M.

From the Depart­ment of Tho­racic Sur­gery Uni­ver­sity of ­Parma, ­Parma, Italy


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Back­ground. Post­op­er­a­tive air ­leaks and ­pleural ­residual ­spaces are ­often encoun­tered ­during par­tial ­lung resec­tions and may ­adversely ­affect the imme­diate out­come pro­longing the hos­pital ­stay. At ­present the ­only treat­ment con­sists of main­te­nance of the ­chest ­drainage ­under suc­tion ­until res­o­lu­tion of the ­leaks.
­Methods. ­From Jan­uary 1995 to ­December 1997 the ­authors ­have oper­ated on and sub­se­quently ­treated 12 ­patients pre­senting pro­longed air ­leaks ­with ­residual ­pleural ­spaces ­after lobec­to­mies for ­lung ­cancer. The ­patients under­went respec­tively: ­left or ­right ­lower lobec­to­mies (n=7), ­left ­upper lobec­to­mies (n=3), ­right ­upper lobec­to­mies (n=2). In ­this ­study the air ­leak was con­sid­ered pro­longed if it con­tinued and ­delayed the dis­charge ­after sur­gery ­beyond the post­op­er­a­tive day 8. The pneu­mo­per­i­toneum was car­ried out ­under ­local anes­thesia. The air was insuf­flated ­through a ­needle ­inserted ­just ­above the umbil­ical ­scar as for lapar­os­copic sur­gery ­access up to an ­amount of ­about 1200 cc-1300 cc.
­Results. We ­have ­obtained in all ­cases and ­without com­pli­ca­tions an imme­diate reduc­tion in the air ­leaks and a com­plete res­o­lu­tion of the ­residual ­pleural ­spaces. ­Chest drain­ages ­were ­removed ­from 3 to 4 ­days ­after the pro­ce­dure.
Con­clu­sions. The ­good ­results ­achieved sug­gest ­that ­this pro­ce­dure ­might be con­sid­ered for ­selected ­cases, ­being a ­minor pro­ce­dure, per­formed ­under ­local anes­thesia and ­with min­imum dis­com­fort for the ­patient.

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