Sutureless pneumostasis using polyglycolic acid mesh as artificial pleura during video-assisted major pulmonary resection.
BACKGROUND
Postoperative air leaks impede rehabilitation and prolong hospitalization after pulmonary resection. To promote rehabilitation after video-assisted major pulmonary resection, we attempted to control alveolar air leaks without suturing, using polyglycolic acid mesh as artificial pleura.


METHODS
Forty-five patients undergoing video-assisted major pulmonary resection in our institute were enrolled in this study. Pneumostasis was done for intraoperative air leaks, by combining polyglycolic acid mesh with fibrin glue. We removed the chest tube the day after the air leaks stopped.


RESULTS
Pneumostasis was done for intraoperative air leaks in 28 patients. The air leaks stopped immediately, allowing chest tube removal on postoperative day 1 in all but one patient whose air leak took 1 day longer to disappear. The time of chest tube drainage and the postoperative stay were similar in the patients with and those without intraoperative air leaks (mean 1.0 days vs 1.2 days and 6.8 days vs 7.1 days, respectively). The percentage of predicted forced expiratory volume in one second was significantly lower in patients with, than in those without, intraoperative air leaks (p < 0.05).


CONCLUSIONS
We achieved sutureless pneumostasis using bioabsorbable artificial pleura during video-assisted major pulmonary resection. This method may contribute to reducing hospitalization, especially in patients with poor pulmonary function.
Department of Surgery and Clinical Science, Division of Chest Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan. kaueda@c-able.ne.jp
Kazuhiro
K
Ueda
Toshiki
T
Tanaka
Mitsutaka
M
Jinbo
Takaharu
T
Yagi
Tao-Sheng
TS
Li
Kimikazu
K
Hamano
D000328:Adult; D000368:Aged; D015505:Chest Tubes; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D010994:Pleura; D011013:Pneumonectomy / Q000379:methods*; D011100:Polyglycolic Acid; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D013526:Surgical Mesh; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D013997:Time Factors
D015718:Fibrin Tissue Adhesive; D011100:Polyglycolic Acid