Fujiu Koichi, Miyamoto Hideaki
Department of General Thoracic Surgery, Southern TOHOKU General Hospital, Koriyama, Fukushima, Japan.
Ann Thorac Cardiovasc Surg. 2012;18(3):212-5. doi: 10.5761/atcs.oa.11.01781.
It has been reported that Integran(®), a sheet-type absorbable topical collagen hemostat, is feasible for preventing pulmonary fistula after lung surgery. The most favorable aspect of Integran(®) is that it contains no blood products. However, the microscopic findings of post-surgery application of Integran(®) to the lung are not known. We identified 2 such cases of Integran(®) application, which were carried out a few years earlier, and described the microscopic findings.
In case 1, a 53-year-old man underwent video-assisted left upper lobectomy for primary lung cancer. Integran(®) was applied to the left lower lobe. Completion left pneumonectomy was performed after 2 years and 1 month due to recurrence. In case 2, a 77-year-old woman underwent video-assisted right middle lobectomy for primary lung cancer. Integran(®) was applied to the right upper lobe. Completion right upper lobectomy was performed after 1 year and 8 months due to recurrence.
The repaired visceral pleura of the 2 patients were covered with proliferated collagen fibers. However, there was little infiltration of inflammatory cells and fibroblasts.
The microscopic findings revealed that the ability of Integran(®) to generate inflammation or adhesion is weak, but it has the ability to repair damaged visceral pleura.
据报道，片状可吸收局部胶原蛋白止血剂Integran（®）在预防肺手术后的肺瘘方面是可行的。Integran（®）最有利的方面是它不含血液制品。然而，Integran（®）应用于肺手术后的微观表现尚不清楚。我们确定了2例几年前进行的Integran（®）应用病例，并描述了微观表现。
病例1，一名53岁男性因原发性肺癌接受电视辅助左上叶切除术。Integran（®）应用于左下叶。2年零1个月后因复发进行了全肺切除术。病例2，一名77岁女性因原发性肺癌接受电视辅助右中叶切除术。Integran（®）应用于右上叶。1年零8个月后因复发进行了右上叶切除术。
2例患者修复的脏层胸膜均覆盖有增生的胶原纤维。然而，炎症细胞和成纤维细胞浸润很少。
微观表现显示，Integran（®）引发炎症或粘连的能力较弱，但它具有修复受损脏层胸膜的能力。
