Zentralbl Chir 2021; 146(S 01): S51
DOI: 10.1055/s-0041-1733360
Abstracts

P-114 Autologous blood pleurodesis for the treatment of postoperative air leaks. A systematic review and meta-analysis

I Karampinis
1   Academic Thoracic Center – Thoracic Surgery, University Medical Center Mainz, Mainz, Deutschland
2   Division of Thoracic Surgery, Royal Brompton Hospital, London, Vereinigtes Königreich
,
C Galata
1   Academic Thoracic Center – Thoracic Surgery, University Medical Center Mainz, Mainz, Deutschland
,
A Arani
1   Academic Thoracic Center – Thoracic Surgery, University Medical Center Mainz, Mainz, Deutschland
,
M Grilli
3   Bibliothek, Universitätsmedizin Mannheim, Mannheim, Deutschland
,
S Hetjens
4   Institute of Medical Statistic and Biomathematics, Mannheim, Deutschland
,
M Shackcloth
5   Division of Thoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, Vereinigtes Königreich
,
S Buderi
2   Division of Thoracic Surgery, Royal Brompton Hospital, London, Vereinigtes Königreich
,
K Athanassiadi
6   Division of Thoracic Surgery, Evangelismos General Hospital, Athen, Griechenland
,
D Stamenovic
1   Academic Thoracic Center – Thoracic Surgery, University Medical Center Mainz, Mainz, Deutschland
,
E Rössner
1   Academic Thoracic Center – Thoracic Surgery, University Medical Center Mainz, Mainz, Deutschland
› Author Affiliations
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Hintergrund

Postoperative air leaks are a common complication after lung surgery. They are associated with prolonged hospital stay, increased treatment costs, increased postoperative pain and patient discomfort. The treatment of prolonged air leaks remains versatile. Several treatment alternatives have been proposed such as different types of sealants, chemical pleurodesis up to early surgical revision. The aim of this review is to analyse the impact of autologous blood pleurodesis in a systematic way.


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Material und Methode

A systematic literature research was conducted up until July 2020. Studies including more than 5 adult patients undergoing lung resections were included. Studies in patients receiving blood pleurodesis for pneumothorax were excluded. The search strategy included proper combinations of the MeSH terms ‘air leak’, ‘blood transfusion’ and ‘lung surgery’. The search was not limited by publication type or language. The review was registered in the PROSPERO database.


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Ergebnis

10 studies with a total of 198 patients were included in the analysis. The pooled success rate for sealing the air leak within 48 hours of the blood pleurodesis was 83.7% (95% CI 75.7; 90.3). The pooled incidence of the post-interventional empyema was 1.5% with a pooled incidence of post-interventional fever of 8.6%. There was no publication bias and no correlation between the amount of blood used and the success rate of the pleurodesis.


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Schlussfolgerung

The current evidence supports the idea that the autologous blood pleurodesis leads to a faster healing of postoperative air leaks than conservative treatment. The complication rate is very low provided that the procedure is performed under sterile conditions. Formal recommendations on how to perform the procedure are not possible with the current evidence. A formal randomised controlled trial providing modern evidence is necessary.


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Publication History

Article published online:
06 September 2021

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