Mesh-based pneumostasis contributes to preserving gas exchange capacity and promoting rehabilitation after lung resection.
BACKGROUND
We recently introduced a technique of sutureless, mesh-based pneumostasis for preventing alveolar air leaks after lung resection. To verify the clinical usefulness of this technique, we examined if it can contribute to preserving gas exchange capacity and promoting postoperative rehabilitation.


METHODS
We prospectively collected perioperative data, including arterial oxygen saturation on postoperative day (POD) 1 and the length of postoperative rehabilitation in 100 patients undergoing elective, video-assisted major lung resection for cancer. Before April, 2006, intraoperative air leaks were sealed with the conventional method (control group), and thereafter, with bioabsorbable mesh and glue, without suturing, (treated group). To reduce the bias in comparison of the nonrandomized control group, we paired the treated group with the control group using the nearest available matching method on the estimated propensity score.


RESULTS
Thirty-five patients in the control group were matched to 35 patients in the treated group based on the estimated propensity score. The length of both chest tube drainage and postoperative rehabilitation were significantly shorter in the treated group than in the control group (median, 1 versus 1 d, P = 0.03; 2 versus 3 d, P = 0.01, respectively). The arterial oxygen saturation on POD 1 was significantly higher in the treated group than in the control group (median, 94.0 versus 92.5 %, P = 0.03).


CONCLUSIONS
Mesh-based pneumostasis during video-assisted major lung resection enabled early chest tube removal, preserved postoperative oxygenation capacity, and promoted postoperative rehabilitation, which may facilitate fast-track surgery for patients undergoing video-assisted major lung resection for cancer.
Ueda
Kazuhiro
K
Department of Surgery and Clinical Science, Division of Chest Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan. kaueda@c-able.ne.jp
Tanaka
Toshiki
T
Hayashi
Masataro
M
Li
Tao-Sheng
TS
Tanaka
Nobuyuki
N
Hamano
Kimikazu
K
D000368:Aged; D016022:Case-Control Studies; D015505:Chest Tubes; D020878:Device Removal; D017079:Exercise Tolerance; D005260:Female; D005337:Fibrin; D006706:Homeostasis / Q000502:physiology*; D006801:Humans; D008168:Lung / Q000502:physiology* / Q000601:surgery*; D008175:Lung Neoplasms / Q000534:rehabilitation* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000295:instrumentation / Q000379:methods*; D011100:Polyglycolic Acid; D011446:Prospective Studies; D011659:Pulmonary Gas Exchange / Q000502:physiology*; D012189:Retrospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome; D020535:Video-Assisted Surgery
D011100:Polyglycolic Acid; D005337:Fibrin