Tokuda Ryosuke, Okada Satoru, Ueshima Yasuo, Ikebe Satoshi, Shimomura Masanori, Ishihara Shunta, Furuya Tatsuo, Kameyama Kenji, Inoue Masayoshi
Department of General Thoracic Surgery, Fukuchiyama City-Hospital, Fukuchiyama, Japan.
Division of Thoracic Surgery, Department of Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
Surg Today. 2025 Apr 26. doi: 10.1007/s00595-025-03041-x.
To assess the usefulness of and predictive factors for pleurodesis using 50% glucose solution to treat air leak after pulmonary resection.
The subjects of this retrospective study were 70 patients from three Japanese institutions, who were treated with 50% glucose solution for postoperative air leak between April, 2015 and March, 2023. Air leak was monitored using a digital drainage system. We analyzed the patient characteristics, surgical details, and outcomes. Successful pleurodesis was defined as control of the air leak within two attempts and no recurrence within 1 month after drain removal. Predictors of success were identified using multivariable logistic regression.
Pleurodesis with 50% glucose solution treated air leak successfully in 58 patients (83%), with a median time from resection to pleurodesis of 4 days. Air leak control was achieved within 2 days in 93% of these patients. Air leak volume < 300 mL/min before pleurodesis and an air space rate < 10% calculated on chest radiograph were independent predictors of success. The success rate for patients with both or none of these factors was 97% and 29%, respectively. No life-threatening complications were observed.
Pleurodesis using 50% glucose solution could be useful for managing postoperative air leak, especially in patients with an air leak volume < 300 mL/min and an air space rate < 10%.
评估使用50%葡萄糖溶液进行胸膜固定术治疗肺切除术后漏气的有效性及预测因素。
本回顾性研究的对象为来自日本三家机构的70例患者,他们在2015年4月至2023年3月期间接受了50%葡萄糖溶液治疗术后漏气。使用数字引流系统监测漏气情况。我们分析了患者特征、手术细节和结果。成功的胸膜固定术定义为在两次尝试内控制漏气且拔管后1个月内无复发。使用多变量逻辑回归确定成功的预测因素。
50%葡萄糖溶液胸膜固定术成功治疗了58例患者(83%)的漏气,从切除到胸膜固定术的中位时间为4天。其中93%的患者在2天内实现了漏气控制。胸膜固定术前漏气量<300 mL/min以及胸部X线片计算的气腔率<10%是成功的独立预测因素。具有这两个因素或均无这两个因素的患者成功率分别为97%和29%。未观察到危及生命的并发症。
使用50%葡萄糖溶液进行胸膜固定术可能有助于处理术后漏气,尤其是对于漏气量<300 mL/min和气腔率<10%的患者。