Top

General Thoracic and Cardiovascular Surgery

Published in:

05-03-2023 | Original Article

A series of experiences with TissuePatch™ for alveolar air leak after pulmonary resection

Author: Takahiro Homma

Published in: General Thoracic and Cardiovascular Surgery | Issue 10/2023

Abstract

Objectives

Prolonged air leak after pulmonary resection strongly influences chest tube duration and hospitalization. This prospective study aimed to report a series of experiences with a synthetic sealant (TissuePatch™) and compare them with a combination covering method (polyglycolic acid sheet + fibrin glue) for air leaks after pulmonary surgery.

Methods

We included 51 patients (age: 20–89 years) who underwent lung resection. Patients who presented with alveolar air leak during the intraoperative water sealing test were randomly assigned to the TissuePatch™ or combination covering method groups. The chest tube was removed when there was no air leak over a period of 6 h, and no active bleeding under continuous monitoring using a digital drainage system. The chest tube duration was assessed, and various perioperative factors (such as the index of prolonged air leak score) were evaluated.

Results

Twenty (39.2%) patients developed intraoperative air leak; ten patients received TissuePatch™; and one patient who was receiving TissuePatch™ switched to the combination covering method because of broken TissuePatch™. The chest tube duration, index of prolonged air leak score, prolonged air leak, other complications, and postoperative hospitalization in both groups were similar. No TissuePatch™-related adverse events were reported.

Conclusions

Results from the use of TissuePatch™ were almost similar to those associated with the use of combination covering method in preventing prolonged postoperative air leak after pulmonary resection. Randomized, double-arm studies are required to confirm the efficacy of TissuePatch™ observed during this study.

Available only for authorised users

Seely AJE, Ivanovic J, Threader J, Al-Hussaini A, Al-Shehab D, Ramsay T, et al. Systematic classification of morbidity and mortality after thoracic surgery. Ann Thorac Surg. 2010;90:936–42. https://doi.org/10.1016/j.athoracsur.2010.05.014.CrossRefPubMed

Dugan KC, Laxmanan B, Murgu S, Hogarth DK. Management of persistent air leaks. Chest. 2017;152:417–23. https://doi.org/10.1016/j.chest.2017.02.020.CrossRefPubMedPubMedCentral

Varela G, Jiménez MF, Novoa N, Aranda JL. Estimating hospital costs attributable to prolonged air leak in pulmonary lobectomy. Eur J Cardiothorac Surg. 2005;27:329–33. https://doi.org/10.1016/j.ejcts.2004.11.005.CrossRefPubMed

Sakata KK, Reisenauer JS, Kern RM, Mullon JJ. Persistent air leak—Review. Respir Med. 2018;137:213–8. https://doi.org/10.1016/j.rmed.2018.03.017.CrossRefPubMed

Rivera C, Bernard A, Falcoz PE, Thomas P, Schmidt A, Bénard 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. https://doi.org/10.1016/j.athoracsur.2011.04.033.CrossRefPubMed

Brunelli A, Monteverde M, Borri A, Salati M, Marasco RD, Fianchini A. Predictors of prolonged air leak after pulmonary lobectomy. Ann Thorac Surg. 2004;77:1205–10. https://doi.org/10.1016/j.athoracsur.2003.10.082.CrossRefPubMed

Kim WH, Lee HC, Ryu HG, Yoon HK, Jung CW. Intraoperative ventilatory leak predicts prolonged air leak after lung resection: a retrospective observational study. PLoS ONE. 2017;12:e0187598. https://doi.org/10.1371/journal.pone.0187598.CrossRefPubMedPubMedCentral

Liang S, Ivanovic J, Gilbert S, Maziak DE, Shamji FM, Sundaresan RS, et al. Quantifying the incidence and impact of postoperative prolonged alveolar air leak after pulmonary resection. J Thorac Cardiovasc Surg. 2013;145:948–54. https://doi.org/10.1016/j.jtcvs.2012.08.044.CrossRefPubMed

Malapert G, Hanna HA, Pages PB, Bernard A. Surgical sealant for the prevention of prolonged air leak after lung resection: meta-analysis. Ann Thorac Surg. 2010;90:1779–85. https://doi.org/10.1016/j.athoracsur.2010.07.033.CrossRefPubMed

10.

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. https://doi.org/10.1055/s-0031-1293599.CrossRefPubMed

11.

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. https://doi.org/10.1016/j.athoracsur.2014.11.040.CrossRefPubMed

12.

Hugen N, Hekma EJ, Claessens NJM, Smit HJM, Reijnen MMPJ. Efficacy of an autologous blood patch for prolonged air leak: a systematic review. Ann Thorac Surg. 2022;114:1064–71. https://doi.org/10.1016/j.athoracsur.2021.05.047.CrossRefPubMed

13.

Gilbert S, McGuire AL, Maghera S, Sundaresan SR, Seely AJ, Maziak DE, et al. Randomized trial of digital versus analog pleural drainage in patients with or without a pulmonary air leak after lung resection. J Thorac Cardiovasc Surg. 2015;150:1243–9. https://doi.org/10.1016/j.jtcvs.2015.08.051.CrossRefPubMed

14.

Zhang R, Bures M, Höffler HK, Zinne N, Länger F, Bisdas T, et al. TissuePatch™ as a novel synthetic sealant for repair of superficial lung defect: in vitro tests results. Ann Surg Innov Res. 2012;6:12. https://doi.org/10.1186/1750-1164-6-12.CrossRefPubMedPubMedCentral

15.

Thompson I. A review of the composition and constituent materials of TissuePatch^TM. https://www.tissuemed.com/wp-content/uploads/2015/06/TB2001.pdf. Accessed 2022

16.

Ambridge A. Burst pressure comparison of TissuePatch^TM with three different surgical sealants used in Thoracic Surgery. https://www.tissuemed.com/wp-content/uploads/2015/06/TB26-Burst-Pressure-Performance-TPT.pdf. Accessed 2022

17.

Mandley D. The fate of TissuePatch^TM: tissue response and in vivo degradation. https://www.tissuemed.com/wp-content/uploads/2015/06/CS6401-The-fate-of-TissuePatch.pdf. Accessed 2022

18.

Homma T, Shimada Y, Tanabe K. Decreased postoperative complications, neuropathic pain and epidural anesthesia-free effect of uniportal video-assisted thoracoscopic anatomical lung resection: a single-center initial experience of 100 cases. J Thorac Dis. 2022;14:3154–66. https://doi.org/10.21037/jtd-22-6.CrossRefPubMedPubMedCentral

19.

Homma T, Kitamura N, Ojima T, Akemoto Y, Hida Y, Yoshimura N. Initial experiences of robot-assisted thoracic surgery: safety approach and comparison with video-assisted thoracoscopic surgery. Jpn J Chest Surg. 2019;33:113–21. https://doi.org/10.2995/jacsurg.33.113.CrossRef

20.

Honma T, Shinno H, Miyazawa H, Noto H. Therapeutic strategy for intractable pneumothorax–combined use of bronchial occlusion therapy and high-negative pressure pleurodesis-. Jpn J Chest Surg. 2009;23:114–9. https://doi.org/10.2995/jacsurg.23.114.CrossRef

21.

Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13. https://doi.org/10.1097/01.sla.0000133083.54934.ae.CrossRefPubMedPubMedCentral

22.

National Cancer Institute. Cancer therapy evaluation program. Common terminology criteria for adverse events (CTCAE). v.4.0. https://ctep.cancer.gov/protocolDevelopment/electronic_applications/ctc.htm#ctc_50. Accessed 2022

23.

Homma T, Ojima T, Yamamoto Y, Shimada Y, Akemoto Y, Kitamura N, et al. Utility of the sliding lung sign for the prediction of preoperative intrathoracic adhesions. J Thorac Dis. 2020;12:4224–32. https://doi.org/10.21037/jtd-20-886.CrossRefPubMedPubMedCentral

24.

NITE chemical risk information platform. https://www.nite.go.jp/chem/chrip/chrip_search/systemTop. Accessed 2022

Title: A series of experiences with TissuePatch™ for alveolar air leak after pulmonary resection
Author: Takahiro Homma
Publication date: 05-03-2023
Publisher: Springer Nature Singapore
Published in: General Thoracic and Cardiovascular Surgery / Issue 10/2023
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI: https://doi.org/10.1007/s11748-023-01921-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

A series of experiences with TissuePatch™ for alveolar air leak after pulmonary resection

Abstract

Objectives

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 10/2023

Late outcome of coronary artery bypass grafting with or without mitral repair for moderate or moderate–severe ischemic mitral regurgitation

Thoracic and cardiovascular surgeries in Japan during 2019

Novel reinforcement technique using pre-glued felt strip with Hydrofit® for a distal anastomotic site in acute type A aortic dissection

Blood flow characteristics of the bilateral internal thoracic artery: implications of optimal graft configuration for coronary artery bypass grafting to maximize blood supply

The role and timing of cardiopulmonary bypass in the surgical repair of traumatic cardiac injury

Modification of the Nuss procedure: the crossed bar technique for new subtypes of pectus excavatum