title: Intraoperative bronchial stump air leak control by Progel® application after pulmonary lobectomy.
abstract: Diffuse tracheobronchial calcification is a physiological condition associated with advanced age, especially in women. A calcified bronchus can be fractured during major lung resections (lobectomy, bilobectomy, and pneumonectomy), exposing patients to intraoperative air leakage and broncho-pleural fistula (BPF) occurrence. We retrospectively evaluated the use of Progel® application on the suture line of bronchial stump after pulmonary lobectomy analysing the intraoperative air leak and BPF occurrence. Between January 2014 and December 2014, Progel® was applied in 11 patients who presented intraoperative bronchial fractures after suture resection by mechanical staplers and air leak from bronchial stump, in order to treat air leakage. Patients were 7 men and 4 women, aged between 56 and 81 years (mean age 71.2 ± 12.1 years). Surgical procedures included 6 upper lobectomies (4 right, 2 left), 1 bilobectomy and 4 lower lobectomies (3 right, 1 left). Mean hospital stay was 4.5 ± 2.6 days (2-8 days). None of the patients had postoperative air leakage. No Progel® application-related complications occurred. No other major complications occurred. No mortality occurred. Progel® proved to be useful in treating intraoperative air leakage during major lung resections, particularly those occurring as a result of fracture of the bronchus from a mechanical stapler.
authors.affiliation: Division of Thoracic Surgery, Sant'Andrea Hospital, 'Sapienza' University of Rome, Rome, Italy mohsen.ibrahim@uniroma1.it.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Ibrahim
authors.affiliation: Division of General Surgery, Sant'Andrea Hospital, 'Sapienza' University of Rome, Rome, Italy.
authors.forename: Fioralba
authors.initials: F
authors.lastname: Pindozzi
authors.affiliation: Division of Thoracic Surgery, G. Mazzini Hospital of Teramo, University of L'Aquila, L'Aquila, Italy.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Menna
authors.affiliation: Division of Thoracic Surgery, Sant'Andrea Hospital, 'Sapienza' University of Rome, Rome, Italy.
authors.forename: Erino A
authors.initials: EA
authors.lastname: Rendina
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001980:Bronchi / Q000601:surgery*; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology / Q000628:therapy*; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects*; D012189:Retrospective Studies; D013536:Suture Techniques / Q000009:adverse effects*; D014014:Tissue Adhesives / Q000494:pharmacology*
chemical_list: D014014:Tissue Adhesives
keywords: Lung cancer surgery; Surgery complications