Trial of a novel synthetic sealant in preventing air leaks after lung resection. Ann Thorac Surg 2001 May;71(5):1623-8; discussion 1628-9
Date
06/01/2001Pubmed ID
11383811DOI
10.1016/s0003-4975(01)02537-1Scopus ID
2-s2.0-0034996910 (requires institutional sign-in at Scopus site) 145 CitationsAbstract
BACKGROUND: Postoperative air leaks are a major cause of morbidity after lung resections. This study was designed to evaluate the efficacy and safety of a new synthetic, bioresorbable surgical sealant in preventing air leaks after pulmonary resection.
METHODS: In a multicenter trial, 172 patients undergoing thoracotomy were randomized intraoperatively in a 2:1 ratio to receive surgical sealant applied to sites at risk for air leak after standard methods of lung closure (treatment group) or to have standard lung closure only (control group). The primary outcome variable was the percentage of patients free of air leakage throughout hospitalization. Secondary outcome variables were the control of air leaks intraoperatively and the time to postoperative air leak cessation. Time to chest tube removal, time to hospital discharge, and safety outcomes were also evaluated.
RESULTS: Air leaks were identified before randomization in 89 of 117 patients in the treatment group and in 39 of 55 patients in the control group. Application of the sealant resulted in control of air leaks in 92% of treated patients (p < or = 0.001). A significantly higher percentage of treated patients than control patients remained free of air leaks during hospitalization (39% versus 11%, p < or =0.001). The mean times to last observable air leak were 30.9 hours in the treatment group and 52.3 hours in the control group (p = 0.006). In the treatment group, trends were observed for reduced time to chest tube removal and earlier discharge. No significant difference was identified in postoperative morbidity and mortality between the two groups.
CONCLUSIONS: Air leaks after lung resection occur in most patients. The application of this novel surgical sealant appears to be effective and safe in preventing postoperative air leaks.
Author List
Wain JC, Kaiser LR, Johnstone DW, Yang SC, Wright CD, Friedberg JS, Feins RH, Heitmiller RF, Mathisen DJ, Selwyn MRAuthor
David Johnstone MD Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AcrylatesAdult
Aged
Female
Follow-Up Studies
Humans
Hydrogels
Lung Diseases
Male
Middle Aged
Pneumonectomy
Pneumothorax
Polyethylene Glycols
Postoperative Complications
Tissue Adhesives
Treatment Outcome