[Pleural tent after upper lobectomy--randomized study of it's efficacy and duration of the effect]

The aim of our study is to evaluate the safety, efficacy and also the maximum duration of effect of the pleural tent in reducing the incidence of air leak after upper lobectomy.

Sixty patients who underwent upper lobectomy were prospectively randomized into two groups: 30 patients had creation of pleural tent (group 1) and 30 did not (group 2). The preoperative, operative, and postoperative characteristics of both groups were compared. Then multivariate analyses were used to identify factors predictive of prolonged air leaks and their duration. The reduction of incidences of air leak in the two groups was subsequently compared during successive postoperative periods.

Demographic and clinical profiles of both groups were not statistically different. The tented patients had statistically significant reduction of mean duration of air leak in days (4.9 +/- 1.79 vs 8.2 +/- 4.2), the number of days of a chest tube duration (7.3 +/- 1.14 vs 12.46 +/- 3.6), the length of postoperative in-hospital stay in days (9.4 +/- 1.86 vs 13.6 +/- 2.49), and the hospital stay cost per patient (leva, 3840 +/- 298 vs 5160 +/- 3890). Logistic regression analyses showed that no having creation a pleural tent procedure was the most significant predictive factor of the occurrence and duration of prolonged air leaks. A greater reduction in the duration of air leaks was observed before postoperative day 4 in group 1, and logistic regression analysis showed that having a pleural tent procedure was the most significant predictive factor of air leaks that persisted for less than 4 days.

Pleural tent creation after upper lobectomy is a simple and safe procedure that reduces the duration of air leaks and the hospital stay costs. The benefit from that procedure is achieved before postoperative day 4.