Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
General Thoracic and Cardiovascular Surgery
Published in: General Thoracic and Cardiovascular Surgery 12/2017

01-12-2017 | Original Article

Low-voltage coagulation, polyglycolic acid sheets, and fibrin glue to control air leaks in lung surgery

Authors: Norikazu Kawai, Takeshi Kawaguchi, Shuko Suzuki, Motoaki Yasukawa, Takashi Tojo, Shigeki Taniguchi

Published in: General Thoracic and Cardiovascular Surgery | Issue 12/2017

Login to get access

Abstract

Objective

We evaluated the efficacy of low-voltage coagulation (LVC) with polyglycolic acid (PGA) sheets (Neoveil, GUNZE Ltd., Japan) and fibrin glue to control intraoperative alveolar air leaks after lung surgery.

Methods

We included 176 patients with non-small cell lung cancer who underwent thoracoscopic lobectomies. When alveolar air leak was confirmed after lung resection, we applied LVC system to the pleural defect followed by layers of PGA sheets and fibrin glue (n = 40). We then analyzed postoperative air leaks (rate of occurrence and duration time).

Results

73% of patients (29/40 cases) experienced no postoperative air leaks. Although 11 patients experienced air leaks after surgery, there were no prolonged air leaks (>7 days) (resolution time, 3.5 ± 1.4 days; range, 2–6 days). Two patients required drainage for late-onset air leaks, but their conditions improved without further treatment. There were no further adverse events.

Conclusions

The use of LVC with PGA sheets and fibrin glue following pulmonary resection efficiently prevented both intraoperative air leaks and prolonged air leaks after lung surgery.
Literature
1.
Brunelli A, Varela G, Refai M, Jimenez MF, Pompili C, Sabbatini A, et al. A scoring system to predict the risk of prolonged air leak after lobectomy. Ann Thorac Surg. 2010;90:204–9.CrossRefPubMed
2.
Filosso PL, Ruffini E, Sandri A, Lausi PO, Giobbe R, Oliaro A. Efficacy and safety of human fibrinogen-thrombin patch (TachoSil®) in the treatment of postoperative air leakage in patients submitted to redo surgery for lung malignancies: a randomized trial. Interact Cardiovasc Thorac Surg. 2013;16:661–6.CrossRefPubMedPubMedCentral
3.
Belda-Sanchis J, Serra-Mitjans M, Iglesias Sentis M, Rami R. Surgical sealant for preventing air leaks after pulmonary resections in patients with lung cancer. Cochrane Database Syst Rev. 2010. doi:10.​1002/​14651858.​CD003051.​pub3.
4.
Anegg U, Rychlik R, Smolle-Juttner F. Do the benefits of shorter hospital stay associated with the use of fleece-bound sealing outweigh the cost of the materials? Interact Cardiovasc Thorac Surg. 2008;7:292–6. (discussion 26).CrossRefPubMed
5.
Rivera C, Bernard A, Falcoz PE, Thomas P, Schmidt A, Benard S, et al. Characterization and prediction of prolonged air leak after pulmonary resection: a nationwide study setting up the index of prolonged air leak. Ann Thorac Surg. 2011;92:1062–8. (discussion 68).CrossRefPubMed
6.
Orsini B, Baste JM, Gossot D, Berthet JP, Assouad J, Dahan M, et al. Index of prolonged air leak score validation in case of video-assisted thoracoscopic surgery anatomical lung resection: results of a nationwide study based on the French national thoracic database, EPITHOR. Eur J Cardiothorac Surg. 2015;48:608–11.CrossRefPubMed
7.
Fleisher AG, 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.CrossRefPubMed
8.
Wong K, Goldstraw P. Effect of fibrin glue in the reduction of postthoracotomy alveolar air leak. Ann Thorac Surg. 1997;64:979–81.CrossRefPubMed
9.
McCarthy PM, Trastek VF, Bell DG, Buttermann GR, Piehler JM, Payne WS, et al. The effectiveness of fibrin glue sealant for reducing experimental pulmonary air leak. Ann Thorac Surg. 1988;45:203–5.CrossRefPubMed
10.
Fabian T, Federico JA, Ponn RB. Fibrin glue in pulmonary resection: a prospective, randomized, blinded study. Ann Thorac Surg. 2003;75:1587–92.CrossRefPubMed
11.
12.
Itano H. The optimal technique for combined application of fibrin sealant and bioabsorbable felt against alveolar air leakage. Eur J Cardiothorac Surg. 2008;33:457–60.CrossRefPubMed
13.
Pedersen TB, Honge JL, Pilegaard HK, Hasenkam JM. Comparative study of lung sealants in a porcine ex vivo model. Ann Thorac Surg. 2012;94:234–40.CrossRefPubMed
14.
Gika M, Kawamura M, Izumi Y, Kobayashi K. The short-term efficacy of fibrin glue combined with absorptive sheet material in visceral pleural defect repair. Interact Cardiovasc Thorac Surg. 2007;6:12–5.CrossRefPubMed
15.
Kawai H, Harada K, Ohta H, Tokushima T, Oka S. Prevention of alveolar air leakage after video-assisted thoracic surgery: comparison of the efficacy of methods involving the use of fibrin glue. Thorac Cardiovasc Surg. 2012;60:351–5.CrossRefPubMed
16.
Albes JM, Krettek C, Hausen B, Rohde R, Haverich A, Borst HG. Biophysical properties of the gelatin-resorcin-formaldehyde/glutaraldehyde adhesive. Ann Thorac Surg. 1993;56:910–5.CrossRefPubMed
17.
Hirokawa F, Hayashi M, Miyamoto Y, Iwamoto M, Tsunematsu I, Asakuma M, et al. A novel method using the VIO soft-coagulation system for liver resection. Surgery. 2011;149:438–44.CrossRefPubMed
18.
Sakuragi T, Ohma H, Ohteki H. Efficacy of SOFT COAG for intraoperative bleeding in thoracic surgery. Interact Cardiovasc Thorac Surg. 2009;9:767–8.CrossRefPubMed
19.
Uchiyama A, Miyoshi K, Nakamura K. VIO soft-coagulation system for major pulmonary resections: results in 68 patients with primary lung cancer. Gen Thorac Cardiovasc Surg. 2011;59:175–8.CrossRefPubMed
20.
Toyazaki T, Tomioka Y, Chiba N, Ueda Y, Sakaguchi Y, Gotoh M, et al. Thoracoscopic partial resection without using a stapler (complete republication). Gen Thorac Cardiovasc Surg. 2017;65:449–54.CrossRefPubMed
21.
Ikegami T, Maeda T, Kayashima H, Oki E, Yoshizumi T, Sakaguchi Y, et al. Soft coagulation, polyglycolic acid felt, and fibrin glue for prevention of pancreatic fistula after distal pancreatectomy. Surg Today. 2011;41:1224–7.CrossRefPubMed
22.
Porte HL, Jany T, Akkad R, Conti M, Gillet PA, Guidat A, et al. Randomized controlled trial of a synthetic sealant for preventing alveolar air leaks after lobectomy. Ann Thorac Surg. 2001;71:1618–22.CrossRefPubMed
23.
Wain JC, Kaiser LR, Johnstone DW, Yang SC, Wright CD, Friedberg JS, et al. Trial of a novel synthetic sealant in preventing air leaks after lung resection. Ann Thorac Surg. 2001;71:1623–8. (discussion 28–9).CrossRefPubMed
24.
Ikeda T, Sasaki M, Yamada N, Takamori A, Tanabe S, Okada A, et al. Controlling air leaks using free pericardial fat pads as surgical sealant in pulmonary resection. Ann Thorac Surg. 2015;99:1170–5.CrossRefPubMed
25.
Shintani Y, Inoue M, Funaki S, Kawamura T, Minami M, Okumura M. Clinical usefulness of free subcutaneous fat pad for reduction of intraoperative air leakage during thoracoscopic pulmonary resection in lung cancer cases. Surg Endosc. 2015;29:2910–3.CrossRefPubMed
26.
Murakami J, Ueda K, Tanaka T, Kobayashi T, Kunihiro Y, Hamano K. The validation of a no-drain policy after thoracoscopic major lung resection. Ann Thorac Surg. 2017;104:1005–11.CrossRefPubMed
Metadata
Title
Low-voltage coagulation, polyglycolic acid sheets, and fibrin glue to control air leaks in lung surgery
Authors
Norikazu Kawai
Takeshi Kawaguchi
Shuko Suzuki
Motoaki Yasukawa
Takashi Tojo
Shigeki Taniguchi
Publication date
01-12-2017
Publisher
Springer Japan
Published in
General Thoracic and Cardiovascular Surgery / Issue 12/2017
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI
https://doi.org/10.1007/s11748-017-0829-2

Other articles of this Issue 12/2017

General Thoracic and Cardiovascular Surgery 12/2017 Go to the issue

Case Report

Thoracoscopic left atrial appendectomy and thoracic endovascular aortic repair (TEVAR) in a patient with cardiogenic stroke combined with acute aortic dissection

Original Article

Clinical outcomes of aortic repair in young adult patients with ACTA2 mutations

Original Article

Predictors of primary lung cancer in a solitary pulmonary lesion after a previous malignancy

Case Report

A rare malformation of bilateral superior vena cava with bilateral partial anomalous pulmonary venous connection in the presence of ostium secundum atrial septal defect: management strategies and pitfalls

Acknowledgment

Acknowledgment to reviewers

Case Report

Successful management of antibody-mediated rejection after cardiac transplantation in a patient supported by a left ventricular assist device for more than 3 years