title: Use of a sealant to prevent prolonged air leaks after lung resection: a prospective randomized study.
abstract: BACKGROUND
  Pulmonary air leaks are common complications of lung resection and result in prolonged hospital stays and increased costs. The purpose of this study was to investigate whether, compared with standard care, the use of a synthetic polyethylene glycol matrix (CoSeal®) could reduce air leaks detected by means of a digital chest drain system (DigiVent™), in patients undergoing lung resection (sutures and/or staples alone).
  
  
  METHODS
  Patients who intraoperatively showed moderate or severe air leaks (evaluated by water submersion tests) were intraoperatively randomized to receive just sutures/staples (control group) or sutures/staples plus CoSeal® (sealant group). Differences among the groups in terms of air leaks, prolonged air leaks, time to chest tube removal, length of hospital stay and related costs were assessed.
  
  
  RESULTS
  In total, 216 lung resection patients completed the study. Nineteen patients (18.1%) in the control group and 12 (10.8%) patients in the sealant group experienced postoperative air leaks, while a prolonged air leak was recorded in 11.4% (n=12) of patients in the control group and 2.7% (n=3) of patients in the sealant group. The difference in the incidence of air leaks and prolonged air leaks between the two groups was statistically significant (p=0.0002 and p=0.0013). The mean length of hospital stay was significantly shorter in the sealant group (4 days) than the control group (8 days) (p=0.0001). We also observed lower costs in the sealant group than the control group.
  
  
  CONCLUSIONS
  The use of CoSeal® may decrease the occurrence and severity of postoperative air leaks after lung resection and is associated with shorter hospital stay.
  
  
  BACKGROUND
  Not registered. The trial was approved by the Institutional Review Board of the IRCCS-CROB Basilicata Regional Cancer Institute, Rionero in Vulture, Italy.
authors.affiliation: Department of Thoracic Surgery, IRCCS-CROB Centro Riferimento Oncologico Basilicata, Rionero in Vulture, PZ, Italy. cosimo.lequaglie@crob.it
authors.forename: Cosimo
authors.initials: C
authors.lastname: Lequaglie
authors.forename: Gabriella
authors.initials: G
authors.lastname: Giudice
authors.forename: Rita
authors.initials: R
authors.lastname: Marasco
authors.forename: Aniello Della
authors.initials: AD
authors.lastname: Morte
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Gallo
mesh_terms: D000368:Aged; D000388:Air; D015505:Chest Tubes; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008171:Lung Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods*; D011030:Pneumothorax / Q000517:prevention & control*; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011446:Prospective Studies; D014014:Tissue Adhesives / Q000008:administration & dosage*
chemical_list: C513322:CoSeal; D014014:Tissue Adhesives; D011092:Polyethylene Glycols