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This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Alessandro Brunelli Majed Al Refai Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Brunelli, A. Articles by Fianchini, A. Search for Related Content PubMed Articles by Brunelli, A. Articles by Fianchini, A. Related Collections Lung - other Related Article

Ann Thorac Surg 2001;71:2083
© 2001 The Society of Thoracic Surgeons

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Correspondence

Pleural tent after upper lobectomy: routine or selective? Reply

^a Department of Thoracic Surgery, University of Ancona, Via S. Margherita 23, 60129 Ancona, Italy

e-mail: alexit{at}freemail.it

To the Editor

We thank Dr Toker and associates for their interest in our study [1]. They stated that the mean air leak duration of their untented patients was similar to our cases with pleural tent, questioning the real value of this procedure found in our analysis. Comparison between works from different centers is always troublesome, especially if differences in methodology and population exist.

The Toker and associates’ series was compounded by only 27 upper lobectomies retrospectively collected over 6 years, whereas our series of 50 cases (25 untented and 25 with pleural tent) was compiled prospectively over a period of 9 months. Moreover, no data were reported in their communication concerning the patients’ age, spirometric values, blood gas analysis, tumor size and location, presence of pleural adhesion, and stapler line length, rendering a comparison between their patients and ours unreliable, and raising concerns about a possible selection bias in their series.

Furthermore, Dr Toker and associates seem to have overlooked the importance of the results of the logistic regression analysis performed in our article on the entire database. The absence of the pleural tent was the most significant independent variable predicting either the duration of an air leak and the occurrence of a prolonged air leak. In any case, the mean air leak time in our tented patients (1.2 ± 2 days) was less than half of what was reported in the patients of Toker and associates.

Since our study was published, we increased the sample size of our series, and now 100 upper lobectomies are prospectively enrolled and randomized. In this more recent and larger series, we confirm the results reported in our previous article [1], corroborating our conclusion that the routine use of this simple procedure after upper lobectomy is warranted, at least in patients at higher risk of developing postoperative prolonged air leak.

References

1. Brunelli A., Al Refai M., Muti M., Sabbatini M., Fianchini A. Pleural tent after upper lobectomy: a prospective randomized study. Ann Thorac Surg 2000;69:1722-1724.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Alessandro Brunelli Majed Al Refai Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Brunelli, A. Articles by Fianchini, A. Search for Related Content PubMed Articles by Brunelli, A. Articles by Fianchini, A. Related Collections Lung - other Related Article