Abstract: Objective To evaluate the efficacy and safety of intrapleural injection of 50% glucose (hypertonic glucose) combined with 2% lidocaine and continuous negative pressure suction for treatment of prolonged pulmohay air leak (PAL) after thoracoscopic pulmonary resection. Methods A retrospective cohort study was conducted in a group of 56 patients who developed PAL (＞5 days) after thoracoscopic pulmonary resection during the period from January 2023 to December 2024. Patients were divided into two groups: the control group (n=26) who received continuous negative pressure suction alone; The combination group (n=30) who received intrapleural injection of 50% glucose plus lidocaine combined with continuous negative pressure suction. The primary comparisons included were duration of air leak, chest tube indwelling time, post-operative hospital stay, treatment efficacy, and complication rates. Results The combination group showed significantly shorter duration of air leak, chest tube indwelling time, and post-operative hospital stay as compared to control group (P＜0.001). The overall treatment efficacy rate in the combination group was 93.3%,that was significantly higher than 76.9% in the control group (P＜0.05). No significant difference was found in the incidence of complications between the two groups. Conclusions Intrapleural injection of 50% glucose combined with lidocaine and continuous negative pressure suction is a safe and effective method for treatment of PAL after thoracoscopic pulmonary resection. Through multiple synergistic mechanisms, this combined approach significantly shortens the duration of air leak and demonstrates superior outcomes compared to negative pressure suction alone.

Key words: pulmonary resection, thoracoscopy, prolonged pulmonary air leak, hypertonic glucose, lidocaine