Predictive factors and economic impact of prolonged air leak after pulmonary resection

Masaya Yotsukura, Yu Okubo, Yukihiro Yoshida, Kazuo Nakagawa, Shun ichi Watanabe

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)


Objective: Prolonged air leak (PAL) is one of the most common complications after pulmonary resection for lung cancer. This study aimed to identify the factors that predict PAL, and to evaluate the impact of PAL on the development of additional complications and cost of hospitalization. Methods: A total of 2278 patients who underwent pulmonary resection other than pneumonectomy for lung cancer from 2014 to 2018 were retrospectively enrolled in this study. PAL was defined as air leak that continued more than 5 days after the operation. Multivariate analyses were conducted to identify significant predictors of PAL, using clinical information. Development of complications other than PAL, and cost of hospitalization care were also analyzed. Results: PAL was observed in 91 (4.0%) cases. Multivariate logistic regression analysis revealed that the presence of intrathoracic adhesion (odds ratio [OR] 4.476, p < 0.001), smoking history > 20 pack-year (OR 2.441, p = 0.005), male sex (OR 2.269, p = 0.013), and lobectomy or bilobectomy (OR 1.935, p = 0.025) were significant risk factors for PAL. The presence of PAL was related to the development of additional complications (p < 0.001). The cost of hospitalization care in patients with PAL was about 1.3 times higher than that in patients without PAL (p < 0.001). Conclusions: PAL is related to additional complications and higher cost of hospitalization care. Surgeons should pay careful attention to minimize the incidence of PAL in patients with risk factors including intrathoracic adhesion, history of heavy smoking, male sex, and lobectomy or bilobectomy.

Original languageEnglish
Pages (from-to)44-51
Number of pages8
JournalGeneral thoracic and cardiovascular surgery
Issue number1
Publication statusPublished - 2022 Jan
Externally publishedYes


  • Cost of hospitalization
  • Postoperative complication
  • Prolonged air leak
  • Pulmonary resection

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine


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