Department of Thoracic Surgery, School of Medicine and Hospital, Sapporo Medical University, South 1, West 16, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan.
Department of Respiratory Medicine and Allergology, School of Medicine and Hospital, Sapporo Medical University, South 1, West 16, Chuo-ku, Sapporo, Hokkaido, 060-8543, Japan.
Surg Today. 2021 Sep;51(9):1521-1529. doi: 10.1007/s00595-021-02251-3. Epub 2021 Mar 20.
We aimed to compare the efficacy of the VIO soft coagulation system (VSCS) for the treatment of air leaks by sealing with fibrin glue, and also assess the histological alterations that occur after soft coagulation.
A mouse pulmonary air leak model was designed. The pulmonary fistula was subsequently coagulated with the VSCS or sealed with fibrin glue with polyglycolic acid (PGA) sheets. The burst pressure at air leak recurrence was measured in each group, and the results were compared. We also evaluated the histological alterations in the mouse pulmonary air leak model after soft coagulation with the VSCS.
The burst pressure in the soft coagulation group (80 W/Effect 5) (median 42.8; range 35.4-53.8 cmHO) was similar to that in the fibrin glue group (median 41.5; range 34.6-43.9 cmHO) (p = 0.21). Histological examinations revealed that the visceral pleura remained torn, the structure of the pulmonary alveolus was maintained, and the coagulated fistula was covered with a fibrin membrane in the soft coagulation group.
The pressure resistance following soft coagulation was equivalent to that after sealing using fibrin glue with PGA sheets. The air leaks were likely controlled by covering the fistula with a fibrin membrane after soft coagulation with the VSCS.
我们旨在比较 VIO 软凝固系统 (VSCS) 用纤维蛋白胶密封治疗气漏的疗效,并评估软凝固后发生的组织学改变。
设计了一种小鼠肺空气漏模型。随后用 VSCS 对肺瘘进行凝固或用聚乙二醇酸 (PGA) 片密封纤维蛋白胶。测量每组气漏复发时的爆裂压力,并比较结果。我们还评估了 VSCS 软凝固后小鼠肺空气漏模型的组织学改变。
软凝固组(80 W/Effect 5)的爆裂压力(中位数 42.8;范围 35.4-53.8 cmHO)与纤维蛋白胶组(中位数 41.5;范围 34.6-43.9 cmHO)相似(p=0.21)。组织学检查显示,脏层胸膜仍然撕裂,肺泡结构保持不变,软凝固组的凝固瘘口被纤维蛋白膜覆盖。
软凝固后的耐压性与 PGA 片纤维蛋白胶密封后的耐压性相当。VSCS 软凝固后,用纤维蛋白膜覆盖瘘口可能控制了气漏。