Prospective randomized study evaluating a biodegradable polymeric sealant for sealing intraoperative air leaks that occur during pulmonary resection.
BACKGROUND
To evaluate the safety and effectiveness of a new biodegradable polymeric sealant to close intraoperative air leaks after pulmonary resection.


METHODS
In a multicenter prospective randomized trial, 161 patients with a median age of 67 years old (range 18-85 years old), were randomized in a 2:1 ratio to receive sealant or control for at least one significant air leak (> or = 2.0 mm in size) after pulmonary resection. In the sealant group, all significant air leaks underwent attempted repair by standard methods (sutures, staples, or cautery) prior to the application of sealant. The control group underwent only standard methods. Blood was analyzed for immunologic response. Patients were followed up 1 month after surgery.


RESULTS
Intraoperative air leaks were sealed in 77% of the sealant group compared with 16% in the control group (p < 0.001). The sealant group had significantly fewer patients with postoperative air leaks compared with the control group (65% vs 86%, p = 0.005). Median length of hospitalization was 6 days (range, 3-23 days) for the sealant group compared with 7 days (range 4-38 days) for controls (p = 0.028). There was no difference in mortality, morbidity, duration of chest tubes, or immune responses between the two groups.


CONCLUSIONS
This study demonstrates the effectiveness of a biodegradable polymer when used as an adjunct to standard closure methods for sealing significant intraoperative air leaks that develop from pulmonary surgery. Use of the sealant led to a reduction in postoperative air leaks, which may have decreased the length of hospitalization.
Allen
Mark S
MS
Division of General Thoracic Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA. allen.mark@mayo.edu
Wood
Douglas E
DE
Hawkinson
Ronald W
RW
Harpole
David H
DH
McKenna
Robert J
RJ
Walsh
Garrett L
GL
Vallieres
Eric
E
Miller
Daniel L
DL
Nichols
Francis C
FC
Smythe
W Roy
WR
Davis
Robert D
RD
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001673:Biodegradation, Environmental; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000628:therapy*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects*; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011446:Prospective Studies; D013501:Surface-Active Agents / Q000627:therapeutic use; D014014:Tissue Adhesives / Q000627:therapeutic use*
D013501:Surface-Active Agents; D014014:Tissue Adhesives; D011092:Polyethylene Glycols