Microscopic findings of sheet-type collagen applied to air leaks after pulmonary resection.
OBJECTIVE
It has been reported that Integran(®), a sheet-type absorbable topical collagen hemostat, is feasible for preventing pulmonary fistula after lung surgery. The most favorable aspect of Integran(®) is that it contains no blood products. However, the microscopic findings of post-surgery application of Integran(®) to the lung are not known. We identified 2 such cases of Integran(®) application, which were carried out a few years earlier, and described the microscopic findings.


METHODS
In case 1, a 53-year-old man underwent video-assisted left upper lobectomy for primary lung cancer. Integran(®) was applied to the left lower lobe. Completion left pneumonectomy was performed after 2 years and 1 month due to recurrence. In case 2, a 77-year-old woman underwent video-assisted right middle lobectomy for primary lung cancer. Integran(®) was applied to the right upper lobe. Completion right upper lobectomy was performed after 1 year and 8 months due to recurrence.


RESULTS
The repaired visceral pleura of the 2 patients were covered with proliferated collagen fibers. However, there was little infiltration of inflammatory cells and fibroblasts.


CONCLUSIONS
The microscopic findings revealed that the ability of Integran(®) to generate inflammation or adhesion is weak, but it has the ability to repair damaged visceral pleura.
Department of General Thoracic Surgery, Southern TOHOKU General Hospital, Koriyama, Fukushima, Japan.
Koichi
K
Fujiu
Hideaki
H
Miyamoto
D000368:Aged; D003094:Collagen / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006489:Hemostatic Techniques / Q000009:adverse effects; D006490:Hemostatics / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011013:Pneumonectomy / Q000009:adverse effects* / Q000379:methods; D011030:Pneumothorax / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D012086:Reoperation; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome
D006490:Hemostatics; C059821:atelocollagen; D003094:Collagen