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Current Thoracic Surgery 2019 , Vol 4 , Issue 3
Rediscovering the legendary treatment of prolonged air leak: therapeutic pneuomoperitoneum
Şevki Mustafa Demiröz1,Göktürk Fındık1,İlteriş Türk1,Koray Aydoğdu1,Funda İncekara1,Sadi Kaya1
1Department of Thoracic Surgery, University of Health Sciences, Ankara Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey DOI : 10.26663/cts.2019.00125 Viewed : 5186 - Downloaded : 1813 Background: Therapeutic pneumoperitoneum was first described for overcoming pulmonary tuberculosis in the end of 19th century. However, in time, another indication “prolonged air leak” (PAL) after major lung resections, lung volume reduction surgery and decortication operations have come on the scene and this legendary treatment have took place again. Despite the developing technology, medical devices and tools thoracic surgeons still sometimes need to use this treatment to cope with PAL.

Materials and Methods: Twelve patients underwent pulmonary operations were included. Nine of the patients had PAL and three had massive air leak with subcutaneous emphysema in early postoperative period. On mean postoperative 8th day (1-15), a one session pneumoperitoneum was applied. In order to fulfill the vascular bed to prevent from air embolism, all of the patients received 500-1500cc of intravenous saline so that the venous pressure is between 7 and 12.

Results: All 12 patients developed no sequel or chronic complications due to the intervention. Mean hospital stay after the intervention was 8.1 days (2-12), mean chest tube removal time after pneumoperitoneum was 16 days (2-48). Six of the patients were discharged with a complete success (without a chest tube), five patients were discharged with a Heimlich valve and one with passive drainage catheter, but the latter patients were also fully recovered in following days.

Conclusions: In this report, we present 12 cases treated successfully with therapeutic pneumoperitoneum without any severe complications. The unique side of our technique is we used only single application without any need of extra instruments. Keywords : prolonged air leak, pneumoperitoneum, lung resection