Division of Thoracic Surgery, Kurobe City Hospital, 1108-1 Mikkaichi, Kurobe, Toyama, 938-8502, Japan.
Division of Thoracic Surgery, University of Toyama, Toyama, Japan.
Gen Thorac Cardiovasc Surg. 2023 Oct;71(10):570-576. doi: 10.1007/s11748-023-01921-y. Epub 2023 Mar 5.
Prolonged air leak after pulmonary resection strongly influences chest tube duration and hospitalization. This prospective study aimed to report a series of experiences with a synthetic sealant (TissuePatch™) and compare them with a combination covering method (polyglycolic acid sheet + fibrin glue) for air leaks after pulmonary surgery.
We included 51 patients (age: 20-89 years) who underwent lung resection. Patients who presented with alveolar air leak during the intraoperative water sealing test were randomly assigned to the TissuePatch™ or combination covering method groups. The chest tube was removed when there was no air leak over a period of 6 h, and no active bleeding under continuous monitoring using a digital drainage system. The chest tube duration was assessed, and various perioperative factors (such as the index of prolonged air leak score) were evaluated.
Twenty (39.2%) patients developed intraoperative air leak; ten patients received TissuePatch™; and one patient who was receiving TissuePatch™ switched to the combination covering method because of broken TissuePatch™. The chest tube duration, index of prolonged air leak score, prolonged air leak, other complications, and postoperative hospitalization in both groups were similar. No TissuePatch™-related adverse events were reported.
Results from the use of TissuePatch™ were almost similar to those associated with the use of combination covering method in preventing prolonged postoperative air leak after pulmonary resection. Randomized, double-arm studies are required to confirm the efficacy of TissuePatch™ observed during this study.
肺切除术后持续性漏气强烈影响胸腔引流管留置时间和住院时间。本前瞻性研究旨在报告一系列使用合成密封剂(TissuePatch™)的经验,并将其与肺手术后防止漏气的联合覆盖方法(聚乙二醇酸片+纤维蛋白胶)进行比较。
我们纳入了 51 例(年龄 20-89 岁)接受肺切除术的患者。术中水封试验时出现肺泡漏气的患者被随机分配至 TissuePatch™或联合覆盖方法组。当胸腔引流管在 6 小时内无漏气且数字引流系统持续监测下无活动性出血时,即可拔除胸腔引流管。评估胸腔引流管留置时间和各种围手术期因素(如延长漏气评分指数)。
20 例(39.2%)患者术中发生漏气;10 例患者接受了 TissuePatch™治疗;1 例因 TissuePatch™破裂而改用联合覆盖方法。两组的胸腔引流管留置时间、延长漏气评分指数、延长漏气、其他并发症和术后住院时间均相似。未报告与 TissuePatch™相关的不良事件。
TissuePatch™的使用结果与肺切除术后防止延长性术后漏气的联合覆盖方法几乎相似。需要进行随机、双臂研究来确认本研究中观察到的 TissuePatch™的疗效。