Treatment of postoperative air leak with fresh frozen plasma

Postoperative air leak is one of the most common complications after pulmonary resection. A prolonged air leak (PAL) is defined as a persistent air leak over 5 (or 7) days (1), which occurs in approximately 7% to 15% of patients after major pulmonary resection (1-4). PAL also causes other complications. For example, a chest tube that is left in place for an extended period can result in labored breathing, difficult ambulation, and postoperative pneumonia. Chest tube drainage over a long duration causes chronic pain at the site of chest tube insertion. It also increases the length of the hospital stay, leading to increased costs. It is true that empyema is also very likely to occur in patients with PAL (5). Thus, most thoracic surgeons try to prevent air leaks during surgery. An air-leak test can be done by pouring saline solution into the chest cavity to submerge the lungs and then monitoring for air bubbles. If an area of air leakage is localized and visible, lung parenchymal sutures can be performed. There are several methods to prevent air leak during surgery, such as buttressing the staple line, use of topical sealants, and parietal pleural abrasion. Even with such methods, it is impossible to completely prevent postoperative air leaks.