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.

Autor:	Zaraca F; Department of Vascular and Thoracic Surgery, Regional Hospital, Bozen/Bolzano, Italy., Brunelli A; Department of Thoracic Surgery, St. James's University Hospital, Leeds, UK., Pipitone MD; Department of Vascular and Thoracic Surgery, Regional Hospital, Bozen/Bolzano, Italy., Abdellateef A; Department of Cardiothoracic Surgery, Mansoura University Hospital, Mansoura, Egypt., Abu Akar F; Department of Cardiothoracic Surgery, Al-Makassed Charitable Society Hospital, East Jerusalem, Palestine., Augustin F; Department of Visceral, Transplant, and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria., Batchelor T; Department of Thoracic Surgery, Bristol Royal Infirmary, Bristol, UK., Bertani A; Division of Thoracic Surgery and Lung Transplantation, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS ISMETT-UPMC, Palermo, Italy., Crisci R; Division of Thoracic Surgery, Thoracic Surgery Unit, University of L'Aquila, G. Mazzini Hospital, Teramo, Italy., D'Amico T; Department of Surgery, Duke Cancer Institute, Durham, North Carolina, USA., D'Journo XB; Department of Thoracic Surgery, Aix-Marseille Université, APHM, Hôpital Nord, Marseille, France., Droghetti A; Division of Thoracic Surgery, ASST Mantova, Mantova, Italy., Fang W; Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China., Gonfiotti A; Thoracic Surgery Unit, Careggi University Hospital, Florence, Italy., Janík M; Department of Thoracic Surgery, Slovak Medical University, University Hospital Bratislava, Bratislava, Slovakia., Jiménez M; Department of Thoracic Surgery, Salamanca University Hospital, Salamanca, Spain., Kirschbaum A; Department of Visceral, Thoracic and Vascular Surgery, University of Marburg, Marburg, Germany., Kostic M; Clinic for Thoracic Surgery, University Clinical Center of Serbia, University of Belgrade, Belgrade, Serbia., Lazzaro R; Department of Cardiothoracic Surgery, Lenox Hill Hospital, New York, USA., Lucchi M; Division of Thoracic Surgery, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy., Marra A; Department of Thoracic Surgery, Rems-Murr-Klinikum Winnenden, Winnenden, Germany., Murthy S; Department of Thoracic and Cardiovascular Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA., Ng CSH; The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China., Nachira D; Department of General Thoracic Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy., Pardolesi A; Division of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Perkmann R; Department of Vascular and Thoracic Surgery, Regional Hospital, Bozen/Bolzano, Italy., Petersen RH; Department of Cardiothoracic Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark., Pischik V; Department of Thoracic Surgery, St Petersburg City Oncology Center, St Petersburg State University, Saint Petersburg, Russia., Russo MD; Department of Vascular and Thoracic Surgery, Regional Hospital, Bozen/Bolzano, Italy., Opitz I; Department of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland., Spaggiari L; Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy.; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy., Ugalde PA; Department of Thoracic Surgery, Institut Universitaire de Pneumologie et Cardiologie de Quebec, Quebec, Quebec, Canada., Vannucci F; Thoracic Surgery Unit, Hospital Pró-Cardíaco-Botafogo, Rio de Janeiro, Brazil.; Thoracic Surgery Unit, Hospital Central da Polícia Militar, Rio de Janeiro, Brazil., Veronesi G; Department of Thoracic Surgery, Vita-Salute San Raffaele University, Milan, Italy., Bertolaccini L; Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy.
Jazyk:	angličtina
Zdroj:	European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery [Eur J Cardiothorac Surg] 2022 Aug 03; Vol. 62 (3).
DOI:	10.1093/ejcts/ezac211
Abstrakt:	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 (<100 ml/min; 81%), moderate (100-400 ml/min; 71%) and severe (>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. (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
Databáze:	MEDLINE
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