Pleural tenting following upper lobectomies or bilobectomies of the lung to prevent residual air space and prolonged air leak.

OBJECTIVE

Apical residual air space and prolonged air leak are not uncommon entities following resection of upper lobe of the lung. This study was carried out to observe the efficacy of pleural tenting in preventing these problems.

METHODS

This is a prospective randomised study. Pleural tenting after upper or upper and middle lobectomies was performed in 20 patients. In another 20 patients who underwent upper lobectomy or bilobectomy, pleural tenting was not performed. Both groups were compared in respect to durations of postoperative chest tube drainage and hospital stay, amount of total pleural drainage, and the presence of need for any additional intervention for prolonged air leak.

RESULTS

Age, sex, pathology and pulmonary function tests of two groups were similar. Duration of chest tube drainage was shorter in whom pleural tenting was performed when compared to whom pleural tenting was not performed (4.3+/-0.16 days versus 7.40+/-0.68 days, P<0.0001). Mean hospital stay was shorter in tented group (7.60+/-0.4 days versus 9.35+/-0.6 days, P=0.024). Although the mean amount of total pleural drainage was less in tented group (667.5+/-57.7 ml versus 802.5+/-83.3 ml, P=0.1911), the difference was not statistically significant. Three (15%) patients in non-tented group needed an apical chest tube insertion in postoperative period for prolonged air leak with an apical pleural space. Asymptomatic apical residual space was observed in 3 patients in tented group. There was no morbidity in patients in tented group.

CONCLUSION

Pleural tenting following upper lobectomy or bilobectomy of the lung shortens the duration of chest tube drainage and hospital stay, and it prevents apical residual air spaces and related complications. Pleural tenting is safe and relatively simple procedure, which has no associated morbidity.