Use of free subcutaneous fat pad for reduction of intraoperative air leak in thoracoscopic pulmonary resection cases with lung cancer.
Intraoperative alveolar air leaks occur in patients with non-small-cell lung cancer (NSCLC) following a pulmonary resection using thoracoscopic surgery. We showed the efficacy of covering damaged lung tissue with a subcutaneous fat pad for preventing postoperative air leak. Thoracoscopic surgery was performed for NSCLC patients with three incisions along with a 3-4 cm anterior utility incision. When an air leak originated from deep within the pulmonary parenchyma or was large, a subcutaneous fat pad ∼2 × 2 cm in size was harvested from the utility incision and placed on the damaged lung tissue with fibrin glue and 2-3 mattress sutures. Subcutaneous fat pads were used for 50 patients with NSCLC during thoracoscopic surgery procedures. There were no intraoperative complications in any of the patients. A prolonged air leak (>7 days) was noted in 3 (6%) of the 50 patients. Air leak was diminished at 1.5 ± 2.6 postoperative days and the chest tubes removed at 3.2 ± 2.8 postoperative days. Reinforcement of damaged lung tissues by use of subcutaneous free fat pads is a safe and intriguing procedure in NSCLC patients who underwent a pulmonary resection in thoracoscopic surgery.
Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan yshintani@thoracic.med.osaka-u.ac.jp.
Yasushi
Y
Shintani
Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Masayoshi
M
Inoue
Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Tomoyuki
T
Nakagiri
Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Meinoshin
M
Okumura
D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery; D015331:Cohort Studies; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D008168:Lung / Q000601:surgery*; D008175:Lung Neoplasms / Q000601:surgery; D011013:Pneumonectomy; D050151:Subcutaneous Fat / Q000601:surgery*; D013906:Thoracoscopy / Q000379:methods*
Air leak; Lung cancer; Subcutaneous fat pad; Thoracoscopy