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

Copyright © 2000 EDIZIONI MINERVA MEDICA

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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