[Management of Postoperative Prolonged Air Leak]

Area of Science:

• Thoracic Surgery
• Pulmonary Medicine
• Surgical Complications

Background:

• Prolonged air leak is a frequent complication following thoracic surgery, particularly after lung resections.
• Defined as air leak persisting >5-7 days post-elective partial lung resection.
• Predictive factors include preoperative (e.g., obstructive pulmonary disease) and intraoperative (e.g., pleural adhesions) elements.

Purpose of the Study:

• To review the current understanding of prolonged air leak in thoracic surgery.
• To discuss predictive factors, diagnostic approaches, and treatment strategies.
• To highlight the need for standardized treatment protocols.

Main Methods:

• Review of literature on prolonged air leak in thoracic surgery.
• Analysis of predictive factors (preoperative and intraoperative).
• Discussion of current treatment modalities: conservative therapy, sclerosing agents, endoscopic procedures, and surgical revision.

Main Results:

• Multiple risk factors contribute to prolonged air leak development.
• Treatment is currently individualized, requiring significant surgical expertise.
• Four main treatment options exist, often used sequentially.

Conclusions:

• Standardized risk identification and diagnostics are established.
• Individualized treatment for prolonged air leak necessitates expert surgical judgment.
• Adopting a standardized therapy sequence within institutions is advisable for effective, targeted treatment.