Abstract
Background
In the present study we present a unique maneuver, using both fibrin glue and polyglycolic acid (PGA) sheets, for repairing intraoperative pulmonary air leakage, and report our clinical results.
Methods
Based on the results from in vitro experiments, we retrospectively investigated the clinical effects of our method for repairing intraoperative pulmonary air leakage in 377 consecutive patients, who underwent a pulmonary resection for primary lung cancer or metastatic lung tumors from 2004 to 2009. From April 2004 through September 2007, repair of intraoperative pulmonary air leakage was performed in 204 patients using only fibrin glue. From October 2007 through December 2009, the repair was performed in 173 patients with a unique application of both fibrin glue and PGA sheets, i.e., (1) rubbing fibrin glue A solution, (2) applying a PGA sheet cut to an appropriate size, (3) rubbing fibrin glue B solution on the PGA sheet, and (4) reapplying fibrin glue A solution and rubbing.
Results
The mean duration of postoperative pleural drainage was significantly shorter in the latter time period when both fibrin glue and PGA sheets were used than in the former period when fibrin glue was used alone. The incidence of prolonged air leakage longer than 1 week was also significantly lower in the latter era than in the former era.
Conclusion
Our unique application of both fibrin glue and PGA sheets for the intraoperative repair of pulmonary air leakage effectively resulted in a shortening of the duration of postoperative pleural drainage.
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References
Lackey A, Mitchell JD (2010) The cost of air leak: physicians’ and patients’ perspectives. Thorac Surg Clin 20:407–411
Shoji F, Yano T, Yoshino I, Kawano D et al (2009) The dynamics and clinical significance of alpha 2 plasmin inhibitor–plasmin complex and thrombin–antithrombin complex in postoperative pleural effusion following a pulmonary lobectomy. Surg Today 39:320–325
Cerfolio RJ, Bass C, Katholi CR (2001) Prospective randomized trial compares suction versus water seal for air leaks. Ann Thorac Surg 71:1613–1617
Okamoto J, Okamoto T, Fukuyama Y et al (2006) The use of a water seal to manage air leaks after a pulmonary lobectomy: a retrospective study. Ann Thorac Cardiovasc Surg 12:242–244
Bertholet JWM, Joosten JJA, Keemers-Gels ME et al (2010) Chest tube management following pulmonary lobectomy: change of protocol results in few air leaks. Interact Cardiovasc Thorac Surg 112:28–31
Porte HL, Jany T, Akkad R et al (2001) Randomized controlled trial of a synthetic sealant for preventing alveolar leaks after lobectomy. Ann Thorac Surg 71:1618–1622
Kawamura M, Gika M, Izumi Y et al (2005) The sealing effect of fibrin glue against alveolar air leakage evaluated up to 48 h; comparison between different methods of application. Eur J Cardiothorac Surg 28:39–42
Fabian T, Federico JA, Ponn RB (2003) Fibrin glue in pulmonary resection: a prospective, randomized, blinded study. Ann Thorac Surg 75:1587–1592
Miyamoto H, Futagawa T, Wang Z et al (2003) Fibrin glue and bioabsorbable felt patch for intraoperative intractable air leaks. Jpn J Thorac Cardiovasc Surg 51:232–236
Ueda K, Tanaka T, Jinbo M et al (2007) Sutureless pneumostasis using polyglycolic acid mesh as artificial pleura during video-assisted major pulmonary resection. Ann Thorac Surg 84:1858–1861
Uehara T, Yano T, Kuninaka S et al (2000) The influence of enhanced postoperative inflammation by the intrapleural administration of streptococcal preparation (OK432) on the prognosis of completely resected non-small-cell lung cancer. J Surg Oncol 5:51–54
Ueda K, Tanaka T, Jinbo M et al (2010) Sutureless pneumostasis using bioabsorbable mesh and glue during major pulmonary resection for cancer: who are the best candidates? J Thorac Cardiovasc Surg 139:100–105
Terasaka S, Iwasaki Y, Shinya N, Uchida T (2006) Fibrin glue and polyglycolic acid nonwoven fabric as a biocompatible dual substitute. Neurosurgery 58:134–139
Yano T, Shoji F, Koga T (2006) Is oxygen supplementation needed after standard pulmonary resection for primary lung cancer? Ann Thorac Cardiovasc Surg 12:393–396
Gika M, Kawamura M, Izumi Y, Kobayashi K (2007) The short-term efficacy of fibrin glue combined with absorptive sheet material in visceral pleural defect repair. Interact Cardiovasc Thorac Surg 6:12–15
Nakamura T, Suzuki K, Mochizuki T et al (2010) An evaluation of the surgical morbidity of polyglycolic acid felt in pulmonary resections. Surg Today 40:734–737
Acknowledgments
We thank the Chemo-Therapeutic Research Institute, Kumamoto, Japan, for their valuable experimental assistance.
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The authors have no conflicts of interests to disclose.
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Yano, T., Haro, A., Shikada, Y. et al. A Unique Method for Repairing Intraoperative Pulmonary Air Leakage with Both Polyglycolic Acid Sheets and Fibrin Glue. World J Surg 36, 463–467 (2012). https://doi.org/10.1007/s00268-011-1355-5
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DOI: https://doi.org/10.1007/s00268-011-1355-5