AUTHOR=Ma Qingyun , Tarabrin Evgeniy A. , Berikkhanov Zelimkhan G. , Ivanova Milena Yu 

TITLE=Risk factors and clinical impact of prolonged air leak following video-assisted thoracoscopic surgery: a retrospective cohort study

JOURNAL=Frontiers in Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1549765

DOI=10.3389/fmed.2025.1549765

ISSN=2296-858X

ABSTRACT=ObjectiveThis study aims to reveal the incidence and risk factors of prolonged air leak (PAL) following video-assisted thoracoscopic surgery (VATS) and to evaluate its impact on postoperative outcomes.MethodsA retrospective analysis was performed on the clinical data of all pulmonary surgery patients who underwent VATS at the Department of Hospital Surgery No.2 at Sechenov University, from September 2023 to September 2024. Patients were categorized into two groups based on the presence of PAL (defined as prolonged air leak lasting ≥ 5 days): the PAL group and the non-PAL group. Risk factors for PAL and its effects on postoperative recovery were assessed.ResultsA total of 110 patients were included in the study, with an incidence of PAL of 26.3%. Multivariate analysis identified chronic obstructive pulmonary disease (COPD) (OR = 9.023, P = 0.003) and pleural adhesions (OR = 3.404, P = 0.013) as independent risk factors for the development of PAL. Significant differences were found between the PAL and non-PAL groups in terms of length of hospital stay (P < 0.001) and chest tube removal time (P < 0.001). The PAL group had a higher overall complication rate than the non-PAL group, with significantly more postoperative pneumonia (P = 0.003), postoperative empyema (P = 0.023), and postoperative wound infections (P = 0.005).ConclusionChronic obstructive pulmonary disease and pleural adhesions were identified as independent risk factors for PAL after VATS. Patients with PAL experienced more postoperative complications and longer hospital stays.