Comparison of 40% Glucose Solution and Autologous Blood Patch Pleurodesis for the Treatment of Postoperative Air Leak after Lung Resections: A Prospective Randomized Controlled Study

Abstract

Objectives Postoperative air leak is among the most common complications in thoracic surgery. Current management strategies are often suboptimal. Intrapleural administration of a glucose solution has emerged as a novel therapeutic approach; however, its clinical value has not been thoroughly investigated. This study aimed to compare the effectiveness of intrapleural 40% glucose solution vs autologous blood patch pleurodesis in managing postoperative air leak. Methods This prospective, randomized, controlled study enrolled patients who underwent anatomical lung resections (segmentectomy, lobectomy, or bilobectomy) at the Department of Thoracic Surgery, Poznan University of Medical Sciences, between November 2023 and December 2024. Patients with postoperative air leak were randomized to receive either 40% glucose (study group) or autologous blood (control group). The primary end-point was cessation of postoperative air leak. Secondary end-points included incidence of residual air space, chest pain, and reoperation. Results A total of 110 patients were included: 47 in the glucose group and 63 in the blood group. Glucose administration resulted in a higher rate of postoperative air leak resolution (95.7% vs 82.5%, P =. 033; 95% CI: 2.2% to 24.2%). The glucose group had a shorter postoperative hospital stay (7 vs 9 days, P =. 036). Chest pain occurred more frequently in the glucose group, but the difference was not statistically significant (10.6% vs 4.8%, P =. 24). No major infectious complications were observed. Residual air space occurrence and reoperation rates were comparable. Conclusions Intrapleural 40% glucose solution achieved a higher resolution rate of postoperative air leak compared to autologous blood patch pleurodesis, with a comparable safety profile. Clinical Registration Number NCT06936969 (ClinicalTrials.gov).