Autologous Blood Patch Pleurodesis: A Large Retrospective Multicenter Cohort Study

Area of Science:

• Thoracic Surgery
• Pulmonary Medicine
• Surgical Complications

Background:

• Prolonged air leaks (PAL) affect 10-15% of lung resections, increasing hospital stay.
• Current management for PAL lacks consensus, despite positive data on autologous blood patch pleurodesis (ABPP).

Purpose of the Study:

• To evaluate the effectiveness and safety of autologous blood patch pleurodesis (ABPP) for managing prolonged air leaks (PAL) after lung resection.

Main Methods:

• Retrospective review of 510 patients with PAL post-lobectomy across four centers (2010-2019).
• Propensity score matching created two groups (109 patients each): ABPP for PAL >5 days vs. no ABPP.
• Key outcomes included time to air leak cessation, chest tube removal, hospital stay, reoperation, and complications.

Main Results:

• ABPP significantly reduced chest tube removal time (8.12 vs 9.30 days) and length of hospital stay (10 vs 11 days).
• The ABPP group experienced fewer perioperative complications (6 vs 17) and required fewer additional invasive procedures (0 vs 9) or reoperations (0 vs 4).
• No long-term complications related to ABPP were observed.

Conclusions:

• Autologous blood patch pleurodesis is a safe and effective intervention for prolonged air leaks.
• ABPP shortens hospital stay and facilitates earlier chest tube removal.
• This procedure does not appear to increase complication rates.