Autologous blood patch pleurodesis: a large retrospective multicenter cohort study.

Abstract Background Prolonged air leaks (PAL) complicate 10-15% of lung resections, delaying chest tube removal and prolonging length of hospital stay (LOS). Non consensus exists for managing this common complication, despite favourable 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 composed of patients who received ABPP for PAL of more than 5 days and Group B in which no ABPP or other procedure was performed for PAL unless strictly necessary. Propensity score-matched (PSM) analysis was performed, and 109 patients were included in each group. Time to cessation of air leak and chest tube removal, LOS, reoperation and complications rate were examined. Results After the PSM, ABPP significantly reduced the number of days before chest tube removal (8.12vs9.30,p=0.004), and LOS (10.0vs11.0,p=0.045) with less perioperative complications (6vs17,p=0.015). Furthermore ABPP was related to lower incidence of any additional invasive procedures (0vs9,p=0.002) and reoperation (0vs4,p=0.044). No patient in the ABPP group had long term complications related to pleurodesis. Conclusions ABPP is safe and effective in reducing LOS and leads to earlier chest tube removal without increasing complications.