By Alessandro Brunelli MD

This factor of Thoracic surgical procedure Clinics is dedicated to the prevention and administration of air leak after pulmonary surgery.  regardless of contemporary progresses in surgical strategy and more desirable perioperative care, lengthy air leak continues to be a widespread problem after pulmonary resection.  Articles will handle subject matters resembling the physics and dynamics of the pleural area, possibility components of lengthy air leak, surgical strategies and interoperative measures, using sealants or buttressing fabric; postoperative rescue ideas and postoperative administration of the chest tube, together with using new digitalized platforms and conveyable units.

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Additional resources for Air Leak after Pulmonary Resection (Thoracic Surgery Clinics of North America, Vol 20, Issue 3 Aug10)

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J Thorac Cardiovasc Surg 1999;117:751–8. 24. Porte HL, Jany T, Akkad R, et al. Randomized controlled trial of a synthetic sealant for preventing alveolar air leaks after lobectomy. Ann Thorac Surg 2001;71:1618–22. 25. Wain JC, Kaiser LR, Johnstone DW, et al. Trial of a novel synthetic sealant in preventing air leaks after lung resection. Ann Thorac Surg 2001;71:1623–9. 26. Allen MS, Wood DE, Hawkinson RW, et al. Prospective randomized study evaluating a biodegradeable polymeric sealant for sealing intraoperative air leaks that occur during pulmonary resection.

At 20 days after surgery, it was encased and fragmented and, by 40 days, partially absorbed. 21 The glutaraldehyde-based sealant with the highest cohesive and adhesive strengths was the most effective lung sealant. Clinical evidence Pulmonary resection There has been 1 random- ized study evaluating glutaraldehyde-albumin sealant in pulmonary resection (Table 3). In a single-institution study of 52 patients undergoing pulmonary resection by 1 of 3 surgeons and judged intraoperatively to have an air leak, Tansley and colleagues22 randomized 25 patients to receive a mixture of glutaraldehyde and bovine serum albumin applied to air leaks from the pulmonary surface (treatment) and 27 not (control) (evidence grade 1B) (see Table 3).

Bell JW. Management of the postresection space in tuberculosis. I. Following segmental and wedge resection. J Thorac Surg 1955;29:649–57. Bell JW. Management of the postresection space in tuberculosis. II. Following lobectomy. J Thorac Surg 1956;31:442–51. Bell JW. Management of the postresection space in tuberculosis. III. Role of pre- and postresection thoracoplasty. J Thorac Surg 1956;32:580–92. Brewer LA 3rd, Gazzaniga AB. Phrenoplasty, a new operation for the management of pleural dead space following pulmonary resection.

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