Kouritas Vasileios, Kefaloyannis Emmanouel, Tcherveniakov Peter
Department of Thoracic Surgery, St. James's University Hospital, Leeds, LS9 7TF, UK.
Gen Thorac Cardiovasc Surg. 2018 Oct;66(10):577-580. doi: 10.1007/s11748-018-0924-z. Epub 2018 Apr 25.
Surgical sealants have been used in thoracic surgery in an effort to reduce air leak duration, intercostal drain duration, length of stay and complications. They are instilled over a defect usually treated with other means. We herein present the technique of controlling a difficult to treat defect by directly instilling Bioglue™ alone into a crater, caused during empyema Video-assisted thoracic surgery in a 50-year-old patient with a trapped lung. This deep crater had caused a significant air leak rendering intraoperative ventilation challenging. After instillation, the dependent lung was kept blocked. With this technique, the Bioglue™ polymerized and the air leak was dramatically decreased making ventilation and eventually extubation of the patient feasible. Instillation of Bioglue™ directly into a large lung defect could be a choice of action to decrease complicated air leaks, otherwise impossible to treat with other means, in patients with trapped lung.
外科密封剂已用于胸外科手术，旨在缩短漏气持续时间、肋间引流持续时间、住院时间并减少并发症。它们通常是在采用其他方法治疗的缺损处滴注。在此，我们介绍一种技术，即通过将生物胶（Bioglue™）单独直接滴注到一名50岁肺陷闭患者脓胸电视辅助胸腔手术期间形成的火山口中，来控制难以治疗的缺损。这个深火山口导致了严重漏气，使术中通气具有挑战性。滴注后，患侧肺保持封堵状态。通过这种技术，生物胶（Bioglue™）聚合，漏气显著减少，使患者通气并最终拔管成为可能。对于肺陷闭患者，将生物胶（Bioglue™）直接滴注到较大的肺缺损处可能是减少复杂漏气（否则无法用其他方法治疗）的一种可行措施。
