Autologous Blood Patch Pleurodesis: A Large Retrospective Multicenter Cohort Study

BACKGROUND Prolonged air leaks (PAL) complicate 10% to 15% of lung resections, delaying chest tube removal and prolonging length of hospital stay. No consensus exists for managing this common complication, despite favorable results for autologous blood patch pleurodesis (ABPP) in the literature. The aim of this study was to evaluate the effectiveness and safety of ABPP. METHODS We retrospectively reviewed medical records of 510 patients with PAL after lobectomy in four centers between January 2010 and December 2019. They were divided into two groups: group A consisted of patients who received ABPP for PAL of more than 5 days; and group B was patients for whom no ABPP or other procedure was performed for PAL unless strictly necessary. Propensity score matched analysis was performed, and 109 patients were included in each group. Time to cessation of air leak and chest tube removal, length of hospital stay, reoperation, and complications rate were examined. RESULTS After the propensity score matching, ABPP significantly reduced the number of days before chest tube removal (8.12 vs 9.30, P=.004), and length of hospital stay (10 vs 11 days, P=.045) with fewer perioperative complications (6 vs 17, P=.015). Furthermore, ABPP was related to lower incidence of any additional invasive procedures (0 vs 9, P=.002) and reoperation (0 vs 4, P=.044). No patient in the ABPP group had long-term complications related to pleurodesis. CONCLUSIONS Autologous blood patch pleurodesis is safe and effective in reducing length of hospital stay and leads to earlier chest tube removal without increasing complications. (C) 2022 by The Society of Thoracic Surgeons