A Delphi Consensus report from the "Prolonged Air Leak: A Survey" study group on prevention and management of postoperative air leaks after minimally invasive anatomical resections

Abstract OBJECTIVES This study reports the results of an international expert consensus process evaluating the assessment of intraoperative air leaks (IAL) and treatment of postoperative prolonged air leaks (PAL) utilizing a Delphi process, with the aim of helping standardization and improving pract...

Full description

Saved in:
Bibliographic Details
Published in:European journal of cardio-thoracic surgery 2022-08, Vol.62 (3)
Main Authors: Zaraca, Francesco, Brunelli, Alessandro, Pipitone, Marco Damiano, Abdellateef, Amr, Abu Akar, Firas, Augustin, Florian, Batchelor, Tim, Bertani, Alessandro, Crisci, Roberto, D’Amico, Thomas, D'Journo, Xavier Benoit, Droghetti, Andrea, Fang, Wentao, Gonfiotti, Alessandro, Janík, Miroslav, Jiménez, Marcelo, Kirschbaum, Andreas, Kostic, Marko, Lazzaro, Richard, Lucchi, Marco, Marra, Alessandro, Murthy, Sudish, Ng, Calvin S H, Nachira, Dania, Pardolesi, Alessandro, Perkmann, Reinhold, Petersen, René Horsleben, Pischik, Vadim, Russo, Michele Dario, Opitz, Isabelle, Spaggiari, Lorenzo, Ugalde, Paula A, Vannucci, Fernando, Veronesi, Giulia, Bertolaccini, Luca
Format: Article
Language:English
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract OBJECTIVES This study reports the results of an international expert consensus process evaluating the assessment of intraoperative air leaks (IAL) and treatment of postoperative prolonged air leaks (PAL) utilizing a Delphi process, with the aim of helping standardization and improving practice. METHODS A panel of 45 questions was developed and submitted to an international working group of experts in minimally invasive lung cancer surgery. Modified Delphi methodology was used to review responses, including 3 rounds of voting. The consensus was defined a priori as >50% agreement among the experts. Clinical practice standards were graded as recommended or highly recommended if 50–74% or >75% of the experts reached an agreement, respectively. RESULTS A total of 32 experts from 18 countries completed the questionnaires in all 3 rounds. Respondents agreed that PAL are defined as >5 days and that current risk models are rarely used. The consensus was reached in 33/45 issues (73.3%). IAL were classified as mild (400 ml/min; 74%). If mild IAL are detected, 68% do not treat; if moderate, consensus was not; if severe, 90% favoured treatment. CONCLUSIONS This expert consensus working group reached an agreement on the majority of issues regarding the detection and management of IAL and PAL. In the absence of prospective, randomized evidence supporting most of these clinical decisions, this document may serve as a guideline to reduce practice variation. Prolonged air leak (PAL) after pulmonary resection is a common complication, with a significant impact on the duration of the hospital stay after surgery.
ISSN:1010-7940
1873-734X
DOI:10.1093/ejcts/ezac211