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Complications are not common but include infection, lung abscess, and bronchopleural fistula (a fistula between the pleural space and the bronchial tree). [4] A bronchopleural fistula results when there is a communication between the laceration, a bronchiole, and the pleura; it can cause air to leak into the pleural space despite the placement of a chest tube. [4]
Lung surgery is a type of thoracic surgery involving the repair or removal of lung tissue, [1] and can be used to treat a variety of conditions ranging from lung cancer to pulmonary hypertension. Common operations include anatomic and nonanatomic resections, pleurodesis and lung transplants .
Pulmonary contusion results in bleeding and fluid leakage into lung tissue, which can become stiffened and lose its normal elasticity. The water content of the lung increases over the first 72 hours after injury, potentially leading to frank pulmonary edema in more serious cases. [ 20 ]
Chest tube clogging can lead to retained blood around the heart and lungs that can contribute to complications and increase mortality. [11] A common complication after thoracic surgery that arises within 30–50% of patients are air leaks. If a chest tube clogs when there is an air leak the patient will develop a pneumothorax.
In a pneumonectomy, in which an entire lung is removed, the remaining bronchial stump may leak air, a rare but very serious condition that leads to progressive subcutaneous emphysema. [8] Air can leak out of the pleural space through an incision made for a thoracotomy to cause subcutaneous emphysema. [ 8 ]
As with any surgery, complications may occur. Post lobectomy air leak is a significant clinical problem, [5] and patients undergoing pulmonary resections often present with postoperative air leaks. [6] Other risk factors include infections, reactions to anesthesia, bleeding, pneumothorax and bronchopleural fistula. [7]
A chylothorax is an abnormal accumulation of chyle, a type of lipid-rich lymph, in the pleural space surrounding the lung.The lymphatic vessels of the digestive system normally return lipids absorbed from the small bowel via the thoracic duct, which ascends behind the esophagus to drain into the left brachiocephalic vein.
If after 2–4 days there is still evidence of an air leak, various options are available. Negative pressure suction (at low pressures of –10 to –20 cmH 2 O) at a high flow rate may be attempted, particularly in PSP; it is thought that this may accelerate the healing of the leak. Failing this, surgery may be required, especially in SSP. [15]