Hamaji Masatsugu, Burt Bryan M, Date Hiroshi, Nakamura Tatsuo
Department of Bioartificial Organs, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan.
Department of Thoracic Surgery, Kyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
Gen Thorac Cardiovasc Surg. 2016 Feb;64(2):82-6. doi: 10.1007/s11748-015-0612-1. Epub 2015 Dec 10.
Reoperative pulmonary resection may be associated with a higher rate of postoperative complications secondary to postoperative adhesions. This review was designed to investigate the effect of a bioabsorbable material on postoperative intrapleural adhesions following thoracotomy. A search was performed in PubMed (United States National Library of Medicine) for original studies published in English and investigating a bioabsorbable material in preventing postoperative intrapleural adhesions, using the terms "pleural", "adhesion", and "surgery". Eight animal experimental studies (five rodents and three canines) were eligible for review. No human studies were identified. The type of bioabsorbable material was a sheet in five studies and a powder or spray in three studies. In five studies (62.5 %), a biomaterial included polymers. Six studies (75 %) suggested that a bioabsorbable material was effective in preventing intrapleural adhesions on the basis of statistical analysis. We conclude that a bioabsorbable material may prevent postoperative adhesions following thoracotomy and that available materials may reasonably be applied in clinical practice. Clinical trials on postoperative anti-adhesions are warranted in select patients.
再次肺切除术可能因术后粘连而伴有较高的术后并发症发生率。本综述旨在研究一种生物可吸收材料对开胸术后胸膜内粘连的影响。我们在美国国立医学图书馆的PubMed数据库中进行了检索,以查找发表于英文的、研究生物可吸收材料预防术后胸膜内粘连的原始研究,检索词为“胸膜”、“粘连”和“手术”。八项动物实验研究(五项啮齿动物研究和三项犬类研究)符合综述纳入标准。未检索到人体研究。生物可吸收材料的类型在五项研究中为片状,在三项研究中为粉末或喷雾剂。五项研究(62.5%)中的生物材料包含聚合物。六项研究(75%)经统计分析表明生物可吸收材料在预防胸膜内粘连方面有效。我们得出结论,生物可吸收材料可能预防开胸术后粘连,现有材料可合理应用于临床实践。有必要针对特定患者开展术后抗粘连的临床试验。