Background: Persistent air leak after pulmonary resection is a difficult complication for thoracic surgeons to manage. Objectives: To show the results of our experience treating persistent pleuropulmonary air leak with autologous blood and review the literature on this specific method of treatment. Methods: Retrospective study of patients with persistent aerial pleuropulmonary fistula treated with autologous blood. The patient’s own blood was collected from a peripheral vein and directly introduced through the pleural drain. An inverted siphon was located in the drainage system to avoid prolonged clamping of the drain. This siphon impeded blood return but not air escape. Results: Between January 2001 and August 2008, 27 patients were treated by the above method. Patient age ranged from 2 to 74 years, and 78% were male. Each procedure used a mean quantity of 92 ml blood. Mean persistent air leak time before pleurodesis was 10.6 days and mean time to fistula resolution after pleurodesis was 1.5 days. Twenty-three (85%) patients had persistent pleuropulmonary air leak closed with the above procedure. Conclusion: Treating persistent pleuropulmonary air leak with autologous blood is promising, but further studies are required to quantify its real effectiveness.
The objective of this study was to analyze the outcome of surgical treatment of pulmonary aspergilloma. To that end, we evaluated 14 adult patients so treated between 1981 and 2009 at the Botucatu School of Medicine University Hospital, in the city of Botucatu, Brazil. Data were collected from the medical records of the patients. Ten patients (71%) presented with simple pulmonary aspergilloma, and 4 (29%) presented with complex pulmonary aspergilloma. Hemoptysis was the most common symptom, and tuberculosis was the most prevalent preexisting lung disease. Two patients (14%) underwent surgery on more than one occasion. There were no intraoperative deaths. Half of the patients developed postoperative complications, prolonged air leak and empyema being the most common.Keywords: Pulmonary aspergillosis; Tuberculosis, pulmonary; Thoracic surgery. ResumoO objetivo deste estudo foi analisar o resultado do tratamento cirúrgico de aspergiloma pulmonar. Para tanto, foram avaliados 14 pacientes adultos (7 homens e 7 mulheres) e tratados no Hospital Universitário da Faculdade de Medicina de Botucatu, em Botucatu (SP), entre 1981 e 2009. Dados foram coletados dos registros médicos dos pacientes. Dez pacientes (71%) apresentaram aspergiloma pulmonar simples, e 4 (29%) apresentaram aspergiloma pulmonar complexo. O sintoma mais frequente foi hemoptise, e a pneumopatia preexistente mais prevalente foi tuberculose. Dois pacientes (14%) foram submetidos a mais de um procedimento cirúrgico. Não houve mortalidade operatória. Metade dos pacientes apresentou complicações pós-operatórias, sendo fuga aérea prolongada e empiema as mais frequentes.
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