Incidence of Air Leak in Stapled Versus Hand Sewn Pulmonary Resections

Abstract

Postoperative air leak is a frequent complication after pulmonary resection. Different approaches have been used to control the incidence of air leaks after pulmonary resection. Objectives: To compare stapled pulmonary resection and hand-sewn, i.e. manual pulmonary resection for the incidence and duration of resolution of air leaks. Methods: This was a prospective comparative study, conducted from August 2019 to July 2020 in the Department of Thoracic Surgery Jinnah Postgraduate Medical Centre, Karachi. Patients indicated for pulmonary resection were randomized to either stapled pulmonary resection (Group A) or manually sutured (Group B) pulmonary resection and were followed till their discharge or resolution of air leak. Results: The total number of air leaks in group A was 9 (30%), out of which 8 (26.6%) resolved conservatively and only one (3.3%) required re-exploration and surgical intervention. The total number of air leaks in group B was 7 (25%), out of which 6 (21.4%) resolved conservatively and only one (3.5%) required re-exploration and surgical intervention. The difference was not significant in the incidence of air leak of both groups. Persistent air leak (PAL) was present in 5 (16.6%) patients in group A and 3 (10.7%) patients in group B. Conclusion: Our study suggests that both stapled pulmonary resection and manually sutured pulmonary resection techniques are comparable in terms of incidence of air leak and its resolution. Hence, the choice of technique should be based on parameters, including the technical aspects and surgeon's preference.