Does Fissureless Videothoracoscopic Lobectomy Help for Postoperative Air Leak?

Kara M., Özkan B., Duman S., Erdoğdu E., Sarıgül A., Toker A.

THORACIC AND CARDIOVASCULAR SURGEON, vol.71, no.7, pp.582-588, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 71 Issue: 7
  • Publication Date: 2022
  • Doi Number: 10.1055/s-0043-1760748
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier
  • Page Numbers: pp.582-588
  • Keywords: Lung cancer, VATS, surgery, complications
  • Istanbul University Affiliated: Yes


Background Postoperative air leak is a common problem in patients undergoing pulmonary resections. A conventional fissure dissection technique during videothoracoscopic lobectomy, particularly in patients with fused fissures is very likely to result in parenchymal damage and prolonged air leak (PAL). In contrast, fissureless video-assisted thoracoscopic surgery (VATS) lobectomy may have advantages regarding PAL and hospital stay.Methods We conducted a retrospective study consisting of 103 consecutive patients who underwent a VATS lobectomy either with a conventional or fissureless technique and statistically analyzed the results particularly with respect to PAL, chest tube duration (CTD), and length of hospital stay (LOS).Results We had 21 (20.4%) cases with PAL. Gender ( p = 0.009), histological size of tumor ( p = 0.003), and surgical technique ( p = 0.009) showed statistically significant differences for PAL in contingency tables. Significant predictors for PAL in univariate analysis were male sex ( p = 0.017), histological size of tumor more than 24 mm ( p = 0.005), and conventional technique ( p = 0.017). Similarly, multivariate analysis revealed male sex ( p = 0.036), histological size of tumor more than 24 mm ( p = 0.043), and conventional technique ( p = 0.029) as significant predictors for PAL. In addition, both the medians of CTD ( p = 0.015) and LOS ( p = 0.005) were comparably lesser as 3 days, in patients who underwent fissureless videothoracoscopic lobectomy.Conclusion The fissureless technique helps for PAL in patients undergoing videothoracoscopic lobectomy.