Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan.
World J Surg. 2012 Feb;36(2):463-7. doi: 10.1007/s00268-011-1355-5.
In the present study we present a unique maneuver, using both fibrin glue and polyglycolic acid (PGA) sheets, for repairing intraoperative pulmonary air leakage, and report our clinical results.
Based on the results from in vitro experiments, we retrospectively investigated the clinical effects of our method for repairing intraoperative pulmonary air leakage in 377 consecutive patients, who underwent a pulmonary resection for primary lung cancer or metastatic lung tumors from 2004 to 2009. From April 2004 through September 2007, repair of intraoperative pulmonary air leakage was performed in 204 patients using only fibrin glue. From October 2007 through December 2009, the repair was performed in 173 patients with a unique application of both fibrin glue and PGA sheets, i.e., (1) rubbing fibrin glue A solution, (2) applying a PGA sheet cut to an appropriate size, (3) rubbing fibrin glue B solution on the PGA sheet, and (4) reapplying fibrin glue A solution and rubbing.
The mean duration of postoperative pleural drainage was significantly shorter in the latter time period when both fibrin glue and PGA sheets were used than in the former period when fibrin glue was used alone. The incidence of prolonged air leakage longer than 1 week was also significantly lower in the latter era than in the former era.
Our unique application of both fibrin glue and PGA sheets for the intraoperative repair of pulmonary air leakage effectively resulted in a shortening of the duration of postoperative pleural drainage.
在本研究中，我们提出了一种独特的方法，使用纤维蛋白胶和聚乙醇酸（PGA）片修复术中肺漏气，并报告了我们的临床结果。
根据体外实验的结果，我们回顾性调查了我们的方法在 377 例连续患者中的临床效果，这些患者因原发性肺癌或转移性肺肿瘤于 2004 年至 2009 年接受了肺切除术。从 2004 年 4 月至 2007 年 9 月，204 例患者仅使用纤维蛋白胶修复术中肺漏气。从 2007 年 10 月至 2009 年 12 月，173 例患者使用纤维蛋白胶和 PGA 片的独特应用进行了修复，即（1）摩擦纤维蛋白胶 A 溶液，（2）应用适当大小的 PGA 片，（3）在 PGA 片上摩擦纤维蛋白胶 B 溶液，和（4）重新应用纤维蛋白胶 A 溶液并摩擦。
在使用纤维蛋白胶和 PGA 片的后期，术后胸腔引流的平均持续时间明显短于单独使用纤维蛋白胶的前期。在后期，延长漏气超过 1 周的发生率也明显低于前期。
我们对术中肺漏气的纤维蛋白胶和 PGA 片的独特应用有效地缩短了术后胸腔引流的持续时间。
