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Subcostal Specimen Removal in Completely Portal Robotic Lobectomy

Subcostal Specimen Removal in Completely Portal Robotic Lobectomy

Published on: April 19, 2024

[Prolonged air leak after lobectomy and its impact on 30- and 90-day mortality: a retrospective multiple-center

E A Toneev^1,2, A E Slugin³, S Yu Pushkin^4,5

¹Regional Clinical Oncology Dispensary, Ulyanovsk, Russia.

|July 27, 2026

Abstract

Objective:

To evaluate the impact of PAL on 30- and 90-day mortality and to identify clinical and intraoperative risk factors in patients undergoing anatomical lung resection for malignant tumors.

Material And Methods:

A retrospective multiple-center study included 700 patients who underwent lobectomy between January 2021 and December 2024. PAL was defined as an air leak persisting beyond 5 postoperative days. Univariable and multivariable logistic regression analysis was performed.

Results:

The incidence of PAL was 15.6%. PAL was significantly associated with longer chest drainage duration (median: 16 vs. 7 days), prolonged hospital-stay (21 vs. 11 days) and higher rates of complications TMM grade II-IIIB (p=0.002). Independent risk factors of PAL were low FEV₁ (AOR=0.983), thoracotomy (AOR=2.664) and longer surgery time (AOR=1.009; all p<0.001). PAL was not associated with 30-day mortality but was an independent predictor of 90-day mortality (AOR=2.505; p=0.026). Prognostic model for 90-day mortality showed acceptable accuracy (AUC=0.719).

Conclusion:

PAL occurred in 15.6% of cases and was associated with prolonged recovery and increased 90-day mortality. Key risk factors were low FEV₁, thoracotomy, and longer surgery time.

Keywords:

30- and 90-day mortality lobectomy logistic regression lung resection predictive model prolonged air leak thoracic surgery

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