title: Staple line reinforcement with fleece-coated fibrin glue (TachoComb) after thoracoscopic bullectomy for the treatment of spontaneous pneumothorax.
abstract: BACKGROUND
  We investigated the cause of pneumothorax recurrence after thoracoscopic surgery and the effectiveness of staple line reinforcement with fleece-coated fibrin glue (TachoComb) in the prevention of postoperative pneumothorax recurrence.
  
  
  METHODS
  From April 3, 1992 to the end of December 2005, thoracoscopic bullectomy was performed on 499 patients of primary spontaneous pneumothorax. The causes of recurrence were investigated on 39 patients on the basis of surgical observations, preoperative chest computed tomography, and so on. The most common cause was new bulla formation (37 cases), 19 of which were apparently related to the staple line (within 1 cm of the staple lines) and 15 of which were not related to the staple line. After 2000, we stopped using forceps to grasp lungs and we have reinforced the staple line by applying fleece-coated fibrin glue.
  
  
  RESULTS
  The staple line reinforced with fleece-coated fibrin glue, or sprayed with fibrin glue solution and the untreated group (bullectomy only with staples) were compared, and the recurrence rates were 1.22%, 7.25%, and 10.00%, respectively (P = 0.0006021).
  
  
  CONCLUSIONS
  The recurrence rate after thoracoscopic bullectomy with fleece-coated fibrin glue was significantly lowered and we consider this procedure to be the treatment of choice for the management of spontaneous pneumothorax.
authors: Division of Respiratory Surgery, Department of Surgery, Nihon University School of Medicine, 30-1 Oyaguchikamimachi, Tokyo 173-8610, Japan.
authors: Takashi
authors: T
authors: Muramatsu
authors: Kazumitsu
authors: K
authors: Ohmori
authors: Mie
authors: M
authors: Shimamura
authors: Motohiko
authors: M
authors: Furuichi
authors: Shinji
authors: S
authors: Takeshita
authors: Nanao
authors: N
authors: Negishi
mesh_terms: D001768:Blister / Q000601:surgery*; D015718:Fibrin Tissue Adhesive / Q000494:pharmacology*; D006801:Humans; D011030:Pneumothorax / Q000601:surgery*; D011184:Postoperative Period; D012008:Recurrence; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects*; D013997:Time Factors
chemical_list: D015718:Fibrin Tissue Adhesive
references: Chest. 2002 Jan;121(1):251-5
references: 11796458
references: Surg Endosc. 2002 Apr;16(4):630-4
references: 11972203
references: Eur J Cardiothorac Surg. 1994;8(1):34-6
references: 8136167
references: Ann Thorac Surg. 2003 Nov;76(5):1665-7; discussion 1667
references: 14602306
references: Surg Endosc. 1998 Sep;12(9):1155-8
references: 9716772
references: Ann Thorac Surg. 1996 Feb;61(2):538-41
references: 8572763
references: Ann Thorac Surg. 1993 Sep;56(3):686-7
references: 8379771
references: Ann Thorac Surg. 2004 May;77(5):1802-5
references: 15111189
references: Ann Thorac Surg. 1980 Dec;30(6):569-74
references: 7469577
references: Ann Thorac Surg. 1989 Nov;48(5):651-3
references: 2818054
references: Surg Endosc. 2004 Mar;18(3):478-81
references: 14752657
references: J Cardiovasc Surg (Torino). 2002 Apr;43(2):259-62
references: 11887067
references: Can Respir J. 2001 Sep-Oct;8(5):339-43
references: 11694914
references: Acta Chir Belg. 2002 Dec;102(6):439-44
references: 12561150
references: Int Surg. 2004 Oct-Dec;89(4):185-9
references: 15730096
references: Thorax. 1994 Sep;49(9):922-3
references: 7940436
references: Thorax. 1983 Oct;38(10):737-43
references: 6648852
references: Ir J Med Sci. 2002 Apr-Jun;171(2):71-2
references: 12173891
references: J Laparoendosc Adv Surg Tech A. 2004 Oct;14(5):274-7
references: 15630942
references: Ann Thorac Surg. 2003 Mar;75(3):960-5
references: 12645724
references: Eur J Cardiothorac Surg. 2001 Apr;19(4):396-9
references: 11306302
references: Chest. 2004 Jan;125(1):50-5
references: 14718420