title: Efficacy and safety of human fibrinogen-thrombin patch (Tachosil(®)) in the management of diffuse bleeding after chest wall and spinal surgical resection for aggressive thoracic neoplasms.
abstract: Diffuse bleeding after chest wall and spine resection represents a major problem in General Thoracic Surgery. Several fibrin sealants (FS) have been developed over the years and their use has been gradually increasing over time, becoming an important aid to the surgeons, justifying their use across numerous fields of surgery due to its valid haemostatic properties. Among the several FS available, TachoSil(®) (Takeda Austria GmbH, Linz, Austria) stands out for its haemostatic and aerostatic properties, the latter being demonstrated even in high-risk patients after pulmonary resections for primary lung cancers. Several papers available in literature demonstrated TachoSil(®)'s effectiveness in controlling intraoperative and postoperative bleeding in different surgical branches, including hepatic and pancreatic surgery, as well as cardiac and thoracic surgery. However, the use of TachoSil(®) to control diffuse bleeding following major resections for advanced lung cancers, with requirement of chest wall and vertebral body resection for oncological radicality, was never published so far. In this paper, we report three cases of pulmonary lobectomy associated to chest wall resection and haemivertebrectomy for primary malignant lung neoplasms and for a recurrence of malignant solitary fibrous tumour of the pleura in which we used TachoSil(©), which demonstrated its efficacy in controlling diffuse bleeding following resection.
authors.affiliation: 1 Department of Thoracic Surgery, 2 Unit of Neurosurgery, University of Torino, Via Genova, 3 10126 Torino, Italy ; 3 Unit of Pulmonology, San Giovanni Battista Hospital, 10126 Torino, Italy.
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Filosso
authors.affiliation: 1 Department of Thoracic Surgery, 2 Unit of Neurosurgery, University of Torino, Via Genova, 3 10126 Torino, Italy ; 3 Unit of Pulmonology, San Giovanni Battista Hospital, 10126 Torino, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Guerrera
authors.affiliation: 1 Department of Thoracic Surgery, 2 Unit of Neurosurgery, University of Torino, Via Genova, 3 10126 Torino, Italy ; 3 Unit of Pulmonology, San Giovanni Battista Hospital, 10126 Torino, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Sandri
authors.affiliation: 1 Department of Thoracic Surgery, 2 Unit of Neurosurgery, University of Torino, Via Genova, 3 10126 Torino, Italy ; 3 Unit of Pulmonology, San Giovanni Battista Hospital, 10126 Torino, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Zenga
authors.affiliation: 1 Department of Thoracic Surgery, 2 Unit of Neurosurgery, University of Torino, Via Genova, 3 10126 Torino, Italy ; 3 Unit of Pulmonology, San Giovanni Battista Hospital, 10126 Torino, Italy.
authors.forename: Giovanni Vittorio
authors.initials: GV
authors.lastname: Lanza
authors.affiliation: 1 Department of Thoracic Surgery, 2 Unit of Neurosurgery, University of Torino, Via Genova, 3 10126 Torino, Italy ; 3 Unit of Pulmonology, San Giovanni Battista Hospital, 10126 Torino, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Ruffini
authors.affiliation: 1 Department of Thoracic Surgery, 2 Unit of Neurosurgery, University of Torino, Via Genova, 3 10126 Torino, Italy ; 3 Unit of Pulmonology, San Giovanni Battista Hospital, 10126 Torino, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Bora
authors.affiliation: 1 Department of Thoracic Surgery, 2 Unit of Neurosurgery, University of Torino, Via Genova, 3 10126 Torino, Italy ; 3 Unit of Pulmonology, San Giovanni Battista Hospital, 10126 Torino, Italy.
authors.forename: Paraskevas
authors.initials: P
authors.lastname: Lyberis
authors.affiliation: 1 Department of Thoracic Surgery, 2 Unit of Neurosurgery, University of Torino, Via Genova, 3 10126 Torino, Italy ; 3 Unit of Pulmonology, San Giovanni Battista Hospital, 10126 Torino, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Solidoro
authors.affiliation: 1 Department of Thoracic Surgery, 2 Unit of Neurosurgery, University of Torino, Via Genova, 3 10126 Torino, Italy ; 3 Unit of Pulmonology, San Giovanni Battista Hospital, 10126 Torino, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Oliaro
keywords: Bleeding; chest wall resection; lung cancer; solitary fibrous tumor of the pleura; spine resection