The efficacy and side effects of gelatin-resorcinol formaldehyde-glutaraldehyde (GRFG) glue for preventing and sealing pulmonary air leakage

Abstract

This study was conducted to examine the efficacy and side effects of gelatin-resorcinol formaldehyde-glutaraldehyde (GRFG) glue, when used for preventing or sealing pulmonary air leakage during lung surgery. Formaldehyde-glutaraldehyde (FG) jelly was prepared by mixing FG fluid with 2.5% carboxymethyl cellulose to increase its viscosity. A GRFG glue-spreading stapler was employed to prevent air leakage from the staple line when cutting emphysematous lung tissue in 26 patients, 25 of whom underwent video-assisted thoracoscopic surgery (VATS) and 1, open thoracotomy. A glue-sealing procedure was employed to stop existing pulmonary air leakage in a further 36 patients, 28 of whom underwent VATS and 8, open thoracotomy. The glue-spreading stapler technique prevented air leakage in all 26 patients (100%), while the glue-sealing procedure for pulmonary air leakage stopped air leakage in 31 of the 36 patients (86%). Two patients who underwent glue sealing for air leakage from a deeply cut lung surface suffered massive pulmonary air leakage on postoperative day (POD) 1 and 6, respectively, and required repeat surgery to suture the lung fistula. A transient fever of 38 degrees-39 degrees developed on POD 7 in 6 of the 62 patients (9.7%), but no other complications were observed. These results demonstrated that GRFG is safe and effective in preventing or stopping pulmonary air leakage in the peripheral lung, but not for stopping air leakage from a deeply cut lung.