Postoperative pneumoperitoneum for prolonged air leaks and residual spacesafter pulmonary resections

Background Postoperative air leaks and pleural residual spaces are often en countered during partial lung resections and may adversely affect the immed iate outcome prolonging the hospital stay. At present the only treatment co nsists of maintenance of the chest drainage under suction until resolution of the leaks. Methods. From January 1995 to December 1997 the authors have operated on an d subsequently treated 12 patients presenting prolonged air leaks with resi dual pleural spaces after lobectomies for lung cancer. The patients underwe nt respectively: left or right lower lobectomies (n = 7), left upper lobect omies (n = 3), right upper lobectomies (n = 2). In this study the air leak was considered prolonged if it continued and delayed the discharge after su rgery beyond the postoperative day 8. The pneumoperitoneum was carried out under local anesthesia. The air was Insufflated through a needle inserted j ust above the umbilical scar as for laparoscopic surgery access up to an am ount of about 1200 cc-1300 cc. Results, We have obtained in all cases and without complications an immedia te reduction in the air leaks and a complete resolution of the residual ple ural spaces, Chest drainages were removed from 3 to 4 days after the proced ure. Conclusions. The good results achieved suggest that this procedure might be considered for selected cases, being a minor procedure, performed under lo cal anesthesia and with minimum discomfort for the patient.