Skip to main content
Log in

Cauterization Versus Fibrin Glue for Aerostasis in Precision Resections for Secondary Lung Tumors

  • Original Articles
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background: Aerostasis control in multiple resections for metastatic pulmonary diseases is a real problem. Long-term air leaks prolong postoperative hospitalization and result in an additional financial burden on the healthcare system. We focused our study on the evaluation of fibrin glue (Tissucol) as an effective means to minimize or prevent air leaks.

Methods: We initiated a case-control study whereby 100 patients underwent precision resections for lung metastases. The subjects were divided into 2 groups, both with 50 patients: group 1 was treated with fibrin glue and group 2 with cauterization. Evaluation parameters consisted of the following: air leak duration, expected complications, drain time, and in-hospital stay.

Results: In group 1, air-leak time was 2.68 ± 1.72 days, versus 7.80 ± 8.52 for group 2 (P < .001). In group 1, there were 2% complications, whereas in group 2 there were 28% (P < .001). Drain time was 4.54 ± 1.83 days for group 1 and 9.54 ± 8.35 for group 2 (P < .001). In-hospital stay was 6.54 ± 1.83 days for group 1 and 11.54 ± 8.35 for group 2 (P < .001).

Conclusions:In the group treated with fibrin glue, we observed significant advantages. Our experience shows that the use of fibrin glue can improve aerostasis control in nonanatomical resections with high risk of air leak.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

REFERENCES

  1. Keagy B, Lores M, Starek P, Murray GF, Lucas CL, Wilcox BR. Elective pulmonary lobectomy: factors associated with morbidity and operative mortality. Ann Thorac Surg 1985;40:349–51.

    Article  PubMed  CAS  Google Scholar 

  2. Perelman M. Precision techniques for removal of pathological structures from the lungs. Surgery 1983;11:12–6.

    Google Scholar 

  3. Cooper JD, Perelman M, Todd TRJ, Ginsberg RJ, Patterson GA. Precision cautery excision of pulmonary lesions. Ann Thorac Surg 1986;41:51–3.

    Article  PubMed  CAS  Google Scholar 

  4. Dunn CJ, Goa KL. Fibrin sealant: a review of its use in surgery and endoscopy. Drugs 1999;58:863–86.

    Article  PubMed  CAS  Google Scholar 

  5. Jackson MR. Fibrin sealants in surgical practice: an overview. Am J Surg 2001;182:1S–7S.

    Article  PubMed  CAS  Google Scholar 

  6. Sierra D. Fibrin sealant adhesive systems: a review of their chemistry, material properties and clinical applications. J Biomater Appl 1993;7:309–51.

    Article  PubMed  CAS  Google Scholar 

  7. Turk R, Weidringer W, Hartel W, Blumel G. Closure of lung leaks by fibrin gluing. Experimental investigation and clinical experience. Thorac Cardiovasc Surg 1983;31:185–6.

    Article  PubMed  CAS  Google Scholar 

  8. Bergsland J, Kalmbach T, Balu D, et al. Fibrin seal an alternative to suture repair in experimental pulmonary surgery. J Surg Res 1986;40:340–5.

    Article  PubMed  CAS  Google Scholar 

  9. McCarthy P, Trastek V, Bell D, et al. The effectiveness of fibrin glue sealant for reducing experimental pulmonary air leak. Ann Thorac Surg 1988;45:203–5.

    Article  PubMed  CAS  Google Scholar 

  10. Takagi M, Akiba T, Yamazaki Y, Nariai K, Iwaki T. The wound-healing effect of fibrin glue for tracheal anastomosis in experimental pulmonary surgery. Surg Today 2001;31:845–7.

    Article  PubMed  CAS  Google Scholar 

  11. Thetter O. Fibrin adhesive and its application in thoracic surgery. Thorac Cardiovasc Surg 1981;29:290–2.

    Article  PubMed  CAS  Google Scholar 

  12. Grunewald D. Intraoperative use of fibrin glue sealant in pulmonary surgery. A prospective study on a series of 124 procedures. Ann Chir 1989;43:147–50.

    Google Scholar 

  13. Kjaergard H. Autologous fibrin-glue preparation and clinical use in thoracic surgery. Eur J Cardiothorac Surg 1992;6:52–4.

    Article  PubMed  CAS  Google Scholar 

  14. Mouritzen C, Dromer M, Keinecke H. The effect of fibrin glueing to seal bronchial and alveolar leakages after pulmonary resections and decortications. Eur J Cardiothorac Surg 1993;7:75–80.

    Article  PubMed  CAS  Google Scholar 

  15. Thistletwaite PA, Luketich JD, Ferson PF, Keenan RJ, Jamieson SW. Ablation of persistent air leaks after thoracic procedures with fibrin sealant. Ann Thorac Surg 1999;67:575–7.

    Article  Google Scholar 

  16. Fleisher GA, Evans KG, Nelems B, Finley RJ. Effect of routine fibrin glue use on the duration of air leaks after lobectomy. Ann Thorac Surg 1990;49:133–4.

    Article  PubMed  CAS  Google Scholar 

  17. Wong K, Goldstraw P. Effect of fibrin glue in reduction of post-thoracotomy alveolar air leak. Ann Thorac Surg 1997;64:979–81.

    Article  PubMed  CAS  Google Scholar 

  18. Roth JA, Pass HI, Wesley MN, White D, Putnam JB, Seipp JA. Comparison of median sternotomy and thoracotomy for resection of pulmonary metastases in patients with adult soft-tissue sarcomas. Ann Thorac Surg 1986;42:134–8.

    Article  PubMed  CAS  Google Scholar 

  19. Lewis JJ, Brennan MF. Soft tissue sarcomas. Curr Probl Surg 1996;33:817–72.

    Article  PubMed  CAS  Google Scholar 

  20. Girard P, Grunenwald D, Baldeyrou P, Spaggiari L, Regnard JF, Levasseur P. Resectable lung metastases from colorectal cancer: look at the serum CEA level. Ann Thorac Surg 1996;62:188–9.

    Google Scholar 

  21. Billingsley KG, Burt ME, Jara E, et al. Pulmonary metastases from soft tissue sarcoma. Ann Surg 1999;229:602–12.

    Article  PubMed  CAS  Google Scholar 

  22. Van Geel AN, Hoekstra HJ, Van Coevorden F. Repeated resection of recurrent pulmonary metastatic soft tissue sarcoma. Eur J Surg Oncol 1994;20:436–40.

    PubMed  CAS  Google Scholar 

  23. Kandioler D, Kromer E, Tuchler H, et al. Long-term results after repeated surgical removal of pulmonary metastases. Ann Thorac Surg 1998;65:909–12.

    Article  PubMed  CAS  Google Scholar 

  24. Weiser MR, Downey RJ, Leung DH, Brennan MF. Repeat resection of pulmonary metastases in patients with soft-tissue sarcoma. J Am Coll Surg 2000;191:184–90.

    Article  PubMed  CAS  Google Scholar 

  25. Pastorino U, Valente M, Gasparini M, et al. Lung resection as salvage treatment for metastatic osteosarcoma. Tumori 1988;74:201–6.

    PubMed  CAS  Google Scholar 

  26. Pastorino U, Valente M, Gasparini M, et al. Lung resection for metastatic sarcomas: total survival from primary treatment. J Surg Oncol 1989;40:275–80.

    Article  PubMed  CAS  Google Scholar 

  27. Pastorino U, Valente M, Gasparini M, et al. Median sternotomy and multiple lung resections for metastatic sarcomas. Eur J Cardiothorac Surg 1990;4:477–81.

    Article  PubMed  CAS  Google Scholar 

  28. Pastorino U, Valente M, Santoro A, et al. Results of salvage surgery for metastatic sarcomas. Ann Oncol 1990;1:269–73.

    PubMed  CAS  Google Scholar 

  29. Pastorino U, Gasparini M, Valente M, et al. Primary childhood osteosarcoma: the role of salvage surgery. Ann Oncol 1992;3:S43–S46.

    PubMed  Google Scholar 

  30. Pastorino U, Buyse M, Friedel G, et al. Long term results of lung metastasectomy: prognostic analyses based on 5206 cases. J Thorac Cardiovasc Surg 1997;113:37–49.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Pier Paolo Brega Massone MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Brega Massone, P.P., Magnani, B., Conti, B. et al. Cauterization Versus Fibrin Glue for Aerostasis in Precision Resections for Secondary Lung Tumors. Ann Surg Oncol 10, 441–446 (2003). https://doi.org/10.1245/ASO.2003.05.025

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1245/ASO.2003.05.025

Key Words:

Navigation