Surgical Management of Prolonged Air Leak in Patients with Underlying Emphysema

Prolonged air leak is one of the most common post-operative complications encountered after thoracic surgical operations involving mobilization or resection of lung parenchyma. Air leak typically manifests as persistent bubbling in a chest tube drainage system, but may also present with increasing subcutaneous emphysema or pneumothorax in a post-operative patient. No universal consensus exist as to the exact duration of air leak which constitutes a prolonged air leak, but it is generally regarded to exist if it is present for more than 5 days(14) or 7 days(2, 5-7) after initial surgery. It is an important complication that results in increased length of stay(8-15) and has been associated with other post-operative complications such as pneumonia(12, 14, 16), empyema(9, 10, 16) and ICU re-admission(12).