Autologous Blood Pleurodesis for Postoperative Air Leakage Following Video-Assisted Thoracoscopic Surgery-A Randomized Controlled Trial.
Finn Amundsen Dittberner, Thomas Decker Christensen, Peter Bjørn Licht
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In 30 seconds
This multicentre randomised controlled trial assessed early autologous blood pleurodesis (ABP) for postoperative air leakage after elective video-assisted thoracoscopic surgery. It enrolled patients with leakage greater than 40 mL/min during cough and mobilization on postoperative day 1, comparing standard chest-drain management with or without ABP. Among 268 participants, median chest-drain duration was 3.4 days (95% CI, 3.0-4.9) with ABP versus 5.0 days (95% CI, 4.0-6.8) with standard management (P = .007). ABP also increased the rate of drain removal (HR 1.49; 95% CI, 1.11-2.01; P = .007).
Key findings
- Median chest-drain duration was 3.4 days (95% CI, 3.0-4.9) with ABP versus 5.0 days (95% CI, 4.0-6.8) in controls (P = .007).
- ABP increased the rate of chest-drain removal (HR 1.49; 95% CI, 1.11-2.01; P = .007).
- By postoperative day 7, drains had been removed in 74% of the ABP group and 62% of controls.
Why it matters
Postoperative air leakage can prolong chest drainage and hospitalization. In this randomised trial, early ABP shortened chest-drain duration in patients with measurable leakage after VATS, providing comparative evidence for an intervention where the abstract describes prior evidence as scarce. The findings may inform evaluation of postoperative pathways, while applying specifically to the studied patient group and management criteria.
What to keep in mind
Patients with persistent air leakage beyond postoperative day 7 were censored for individualized management, limiting comparison beyond that point.