Bovine pericardial patch for preventing air leak after thoracoscopic-assisted pulmonary wedge resection: a...

Thoracoscopic wedge resection has become a standard procedure for pulmonary nodule management, yet postoperative air leak (PAL) remains a prevalent complication. While bovine pericardial patches are established in cardiovascular surgery, their utility in pulmonary resection merits further investigation. This study aimed to assess the efficacy of bovine pericardial patches in reducing PAL after thoracoscopic wedge resection and develop a predictive model for clinical utility.

In this single-center retrospective study (2015-2020), we analyzed 2006 thoracoscopic wedge resections at Fujian Medical University Union Hospital, comparing 319 patch-treated cases with 1,687 controls. Primary outcomes included PAL incidence; while secondary outcomes encompassed drainage duration. Univariate and multivariate logistic regression analyses identified risk factors for PAL, and a nomogram was constructed to predict PAL risk.

Baseline characteristics were well-balanced between groups. The bovine pericardial patch group showed a significantly lower PAL incidence (2.8% vs. 13.2%, P < 0.001) and shorter chest tube drainage duration (2.85 ± 1.27 days vs. 3.06 ± 1.67 days, P = 0.033). Multivariate analysis confirmed the bovine pericardium patch as an independent protective factor against PAL (OR: 0.170; 95% CI: 0.079-0.322; P < 0.001). The nomogram incorporating these factors showed good discriminative ability (AUC = 0.739) and clinical utility in decision curve analysis.

Bovine pericardial patch application significantly reduces PAL incidence and shortens chest tube drainage duration after thoracoscopic wedge resection. The predictive nomogram helps identify high-risk patients who would benefit most from this intervention, supporting its use as a cost-effective adjunct in pulmonary surgery.