One hundred consecutive treatments with holmium: YAG laser for pulmonary bullae: especially in conjunction with gelatin-resorcinol formaldehyde-glutaraldehyde glue adhesion.
OBJECTIVE
We have widely used a Ho:YAG laser to treat bullae thoracoscopically.


METHODS
Bullae with broad necks were treated with a Ho:YAG laser thoracoscopically. Because one patient relapsed after application of fibrin glue in the early period, a DEXON (polyglycolic acid) mesh patch soaked in fibrin glue was used through a 2-cm opening in the subsequent cases. Lastly, gelatin-resorcinol formaldehyde-glutaraldehyde (GRFG) glue was applied through a 5-mm opening instead of a DEXON mesh after coagulation.


RESULTS
In the 38 patients patched with DEXON mesh soaked in fibrin glue and 56 patched with GRFG glue after coagulation, none relapsed.


CONCLUSIONS
Combined uses of fibrin glue plus DEXON mesh or GRFG glue were effective when bullae were treated with the Ho:YAG laser. However, the wound was smaller and more cosmetic in the GRFG glue group than in the DEXON mesh plus fibrin glue group.
Kaseda
S
S
Department of Thoracic Surgery, Saiseikai Kanagawa-ken Hospital, Yokohama 221-8601, Japan. kaseda@ra2.so-net.ne.jp
Aoki
T
T
Hangai
N
N
Shimizu
K
K
Kiguchi
H
H
D001768:Blister / Q000473:pathology* / Q000601:surgery*; D003131:Combined Modality Therapy; D004338:Drug Combinations; D004867:Equipment Design; D005500:Follow-Up Studies; D005557:Formaldehyde / Q000494:pharmacology*; D005780:Gelatin / Q000494:pharmacology*; D005976:Glutaral / Q000494:pharmacology*; D006695:Holmium; D006801:Humans; D017075:Laser Coagulation / Q000379:methods*; D008171:Lung Diseases / Q000473:pathology* / Q000601:surgery*; D012016:Reference Values; D012118:Resorcinols / Q000494:pharmacology*; D012680:Sensitivity and Specificity; D013525:Surgical Instruments; D013906:Thoracoscopy / Q000379:methods; D016896:Treatment Outcome
D004338:Drug Combinations; D012118:Resorcinols; C083703:gelatin-resorcin-formaldehyde-glutaraldehyde adhesive; D005557:Formaldehyde; D005780:Gelatin; D005976:Glutaral; D006695:Holmium