title: [Clinical effect of bovine pericardial strips on air leak after stapled pulmonary resection in "frail" patients: early results].
abstract: OBJECTIVE
  Postoperative air leaks and in particular persistent air leaks (>5 days) after pulmonary resection still represent a common complication and the first cause of hospital stay delay. Aim of this experimental trial was to investigate the efficacy of the use of bovine pericardium strips (in terms of reduction of postoperative leakage and hospital stay) in "critical" patients (COPD, emphysema etc.) who underwent pulmonary resection.
  
  
  METHODS
  From October 2010 to February 2011, eight patients (experimental group, Group A) were preoperative selected and underwent pulmonary resection with bovine pericardium strips (Peri-Strips Dry; Synovis ). The inclusion criteria of a "frail patient" were established by a dedicate pneumologist according with clinical and functional data (predicted postoperative FEV1 ranging from 35% and 80% of the theorical predicted value). For comparison, from January 2010 to September 2010, we retrospectively reviewed the data of 28 patients who satisfied the same inclusion criteria and underwent pulmonary resection with standard surgical procedures. This group of patients represents our control group (Group B).
  
  
  RESULTS
  There were no significant differences between the two groups in age, gender, preoperative risk factors for developing a postoperative air leak, preop FEV1 and type of resection. No technical deficiencies in the use of bovine pericardium strips were observed in Group A. Postoperative leakage was significant different in the two groups being persistent air leak detected in 0% in Group A versus 17.8% of Group B (P=0.046). Consequently, chest tube duration (6.75±0.84 days [Group A] vs. 9.70±1.26 days (Group B), P=0.019) and hospital stay (10.13±0.83 days [Group A] vs. 12.95±1.37 days [Group B], P=0.013) were lower in the experimental group.
  
  
  CONCLUSIONS
  Bovine pericardium strips are safe and easy-to-do technique to reduce postoperative air leaks after pulmonary resection in "critical" patients.
authors.affiliation: Divisione di Chirurgia Toracica, Università Cattolica del Sacro Cuore, Roma, Italia. filippo_lococo@yahoo.it
authors.forename: F
authors.initials: F
authors.lastname: Lococo
authors.forename: A
authors.initials: A
authors.lastname: Cesario
authors.forename: S
authors.initials: S
authors.lastname: Margaritora
authors.forename: D
authors.initials: D
authors.lastname: Nachira
authors.forename: A
authors.initials: A
authors.lastname: Cesario
authors.forename: G
authors.initials: G
authors.lastname: Leuzzi
authors.forename: V
authors.initials: V
authors.lastname: Porziella
authors.forename: E
authors.initials: E
authors.lastname: Meacci
authors.forename: M L
authors.initials: ML
authors.lastname: Vita
authors.forename: L
authors.initials: L
authors.lastname: Vita
authors.forename: M T
authors.initials: MT
authors.lastname: Congedo
authors.forename: T M
authors.initials: TM
authors.lastname: Congedo
authors.forename: P
authors.initials: P
authors.lastname: Granone
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D016022:Case-Control Studies; D002417:Cattle; D016330:Frail Elderly; D006801:Humans; D007902:Length of Stay; D008175:Lung Neoplasms / Q000601:surgery*; D010496:Pericardium / Q000637:transplantation*; D011013:Pneumonectomy / Q000009:adverse effects* / Q000379:methods; D011656:Pulmonary Emphysema / Q000209:etiology / Q000601:surgery; D013510:Pulmonary Surgical Procedures / Q000379:methods; D012307:Risk Factors; D017792:Surgical Stapling / Q000379:methods*; D013997:Time Factors; D014183:Transplantation, Heterologous; D016896:Treatment Outcome