Prolonged air leak after reoperative pulmonary resection (with prior ipsilateral chest surgery)

Reoperative pulmonary resection (with prior ipsilateral chest surgery) has been reported to be associated with a high rate of postoperative complications. The objective of this study was to evaluate prolonged air leak (PAL) after reoperative pulmonary resections. We conducted a single-centre retrospective analysis on 100 consecutive patients undergoing ipsilateral reoperative pulmonary resection at our institution between March 2012 and February 2020. We investigated the incidence of PAL after reoperative pulmonary resections in comparison to that after first operations and analysed potentially relevant factors of PAL after reoperations. After reoperations, the incidence of PAL was 24%. The incidence of PAL after reoperations was significantly higher than that after first operations (P < 0.01). On multivariable analysis, anatomical resection (P = 0.03) and thoracotomy approach (P = 0.02) were found to be significant factors associated with the occurrence of PAL, and age was a significant factor associated with chest tube duration (P < 0.01) and length of hospital stay (P < 0.01) after reoperative pulmonary resection. Our study identified significant risk factors of PAL after reoperative pulmonary resections, which would be an important step towards improved management of patients undergoing reoperative pulmonary resections.