Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Jun 1:7:49.
doi: 10.1186/1749-8090-7-49.

A novel approach to control air leaks in complex lung surgery: a retrospective review

Ara Klijian  1
Affiliations

A novel approach to control air leaks in complex lung surgery: a retrospective review

Ara Klijian. J Cardiothorac Surg. .

Abstract

Background: Intra-operative air leaks (IOAL) are common complications of pulmonary surgery. The post-operative management of air leaks requires a chest tube which may lead to longer hospitalization, further medical complications, and increased costs. Sealants have been shown to help control intra-operative air leaks and studies have demonstrated a reduction in chest tube duration and/or length of hospital stay. Nevertheless, systematic reviews have not presented sufficient evidence to recommend their general use in lung resection.

Methods: One hundred and twenty-one consecutive patients who underwent pulmonary surgery with and without Progel® Pleural Air Leak Sealant were reviewed retrospectively. Intra-operative and 3-months postoperative data were assessed for the presence and persistence of air leaks, chest tube duration, the length of hospital stay, and complications.

Results: Seventy patients (57.9%) had IOAL. Thirty-six were treated with Progel in addition to standard intra-operative technique (pleural-sealant group; PSG) and 34 patients were treated only with standard technique (control group; CG). The percentage of post-operative air leaks in the PSG was 11% (1.2% >Grade 2 air leak) compared with 58.8% (6% >Grade 2 air leak) in the CG (p <0.0001, Leaks graded from 1 = small air leak to 7 = large air leak). The median chest tube duration was significantly shorter in the PSG compared with the controls (1.0 versus 2.5 days; p < 0.0001). The median length of hospital stay was 50% lower in the PSG compared with the control group (1.5 versus 3.0 days; p = 0.047). There were no significant differences in complications between the two groups.

Conclusions: The results of this single-center, single surgeon, retrospective review demonstrate a significant reduction in IOAL, chest tube duration, and length of hospital stay in the in patients treated with Progel when compared with standard intra-operative closure management alone. They suggest that the use of a pleural sealant is more effective in reducing alveolar air leaks associated with lung resection compared with standard closure techniques alone and may result in both an improved surgical outcome and a reduction in costs associated with prolonged hospital stay.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Patients with Postoperative Air Leak.
Figure 2
Figure 2
Mean and Median Chest Tube Duration (days).
Figure 3
Figure 3
Mean and Median Length of Hospital Stay (days).
See this image and copyright information in PMC

References

    1. Belda-Sanchis J, Serra-Mitjans Mireia, Iglesias Sentis M, Rami R. Surgical sealant for preventing air leaks after pulmonary resections in patients with lung cancer. Cochrane Database Syst Rev. 2010;1:CD003051. - PMC - PubMed
    1. Allen MS, Wood DE, Hawkinson RW, Harpole DH. et al. Prospective randomized study evaluating a biodegradable polymeric sealant for sealing intraoperative air leaks that occur during pulmonary resection. Ann Thorac Surg. 2004;77:1792–1801. doi: 10.1016/j.athoracsur.2003.10.049. - DOI - PubMed
    1. Lang G, Csekeo A, Stamatis G. et al. Efficacy and safety of topical application of human fibrinogen/thrombin-coated collagen patch (TachoComb) for treatment of air leakage after standard lobectomy. Eur J Cardiothorac Surg. 2004;25:160–166. doi: 10.1016/j.ejcts.2003.11.018. - DOI - PubMed
    1. Marta GM, Facciolo F, Ladegaard L. et al. Efficacy and safety of TachoSil® versus standard treatment of air leakage after pulmonary lobectomy. Eur J Cardiothorac Surg. 2010;38:683–689. doi: 10.1016/j.ejcts.2010.03.061. - DOI - PubMed
    1. Wain JC, Kaiser LR, Johnstone DW. et al. Trial of a novel synthetic sealant in preventing air leaks after lung resection. Ann Thorac Surg. 2001;71:1623–1628. doi: 10.1016/S0003-4975(01)02537-1. discussion 1628–1629. - DOI - PubMed

Publication types

Substances

LinkOut - more resources