Early Autologous Blood Pleurodesis, Could It Effectively Control Postoperative Air Leak?

Background: Prolonged air leak (PAL) after pleuropulmonary excisional surgeries is a nightmare for thoracic surgeons, as it worsens the postoperative outcome in terms of both morbidity and mortality.
Objective: This study aimed to investigate the value of the early autologous blood pleurodesis (EABP) in prophylaxis against PAL following pleural decortication and lung resection surgeries.
Patients and methods: We retrospectively reviewed the medical records of 482 patients who underwent pleuropulmonary excisional surgeries in 2 different centers: Cairo, and Beni Suef University Hospitals from January 2020 to February 2025. Patients were divided into 2 groups: group A (the conventional group including 260 patients with no blood pleurodesis) and group B (EABP group including 222 patients where our blood pleurodesis technique was used). Data regarding postoperative PAL, longer need for the intercostal tube (ICT), broncho-pleural fistula (BPF), reoperation, prolonged intensive care unit (ICU), hospital stays, and early mortality were gathered and analyzed.
Results: The EABP had significantly lowered the incidence of PAL (4 vs. 15 patients) with a shorter need for the intercostal tube (7.39 + 2.86 vs. 10.5 + 2.87), mechanical ventilation time (1.12 ± 0.69 vs. 2.30 ± 089), shorter ICU stay (10.46 + 2.88 vs. 13.92 + 3.17), and a shorter hospital stay (12.68 + 3.26 vs. 13.32 + 3.44). Although not statistically significant, group B showed less incidence of postoperative infected BPF (3 vs. 7) and less need for reoperation (2 vs. 5). There were no early deaths among both groups.
Conclusion: The use of intraoperative early blood patch pleurodesis in patients undergoing pleuropulmonary excisional surgeries significantly guards against PAL and its hustle sequelae.