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 uncommo n entities following resection of upper lobe of the luna. This study,vas ca rried out to observe the efficacy of pleural tenting in preventing these pr oblems. Methods: This is a prospective randomised study. Pleural tenting af ter upper or upper and middle lobectomies was performed in 20 patients. In another 20 patients who underwent upper lobectomy or bilobectomy, pleural t enting was not performed. Both groups were compared in respect to durations of postoperative chest tube drainage and hospital stay, amount of total pl eural drainage, and the presence of need for any additional intervention fo r prolonged air leak. Results: Age, sex, pathology and pulmonary function t ests of two groups were similar. Duration of chest tube drainage was shorte r in whom pleural tenting was performed when compared to whom pleural tenti ng was not performed (4.3 +/- 0.16 days versus 7.40 +/- 0.68 days, P < 0.00 01). Mean hospital stay was shorter in tented group (7.60 +/- 0.4 days vers us 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 gro up. 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 r esidual air spaces and related complications, Pleural tenting is safe and r elatively simple procedure, which has no associated morbidity. (C) 2001 Els evier Science BN. All rights reserved.