By Alessandro Brunelli MD
This factor of Thoracic surgical procedure Clinics is dedicated to the prevention and administration of air leak after pulmonary surgery. regardless of contemporary progresses in surgical strategy and more desirable perioperative care, lengthy air leak continues to be a common problem after pulmonary resection. Articles will tackle themes corresponding to the physics and dynamics of the pleural area, hazard components of lengthy air leak, surgical thoughts and interoperative measures, using sealants or buttressing fabric; postoperative rescue concepts and postoperative administration of the chest tube, together with using new digitalized structures and conveyable units.
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Additional info for Air Leak after Pulmonary Resection (Thoracic Surgery Clinics of North America, Vol 20, Issue 3 Aug10)
A Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue/Desk J4-1, Cleveland, OH 44195, USA b Department of Quantitative Health Sciences, Research Institute, Cleveland Clinic, 9500 Euclid Avenue/Desk JJ-4, Cleveland, OH 44195, USA * Corresponding author. 008 1547-4127/10/$ – see front matter ª 2010 Elsevier Inc. All rights reserved. 1,2 Therefore, it is imperative to minimize its occurrence and adverse consequences. Careful handling of the lung and meticulous operative technique are the foundation to meet these goals.
Mogues T, Li J, Coburn J, et al. IgG antibodies against bovine serum albumin in humans—their prevalence and response to exposure to bovine serum albumin. J Immunol Methods 2005;300:1–11. 32. Kobayashi H, Sekine T, Nakamura T, et al. In vivo evaluation of a new sealant material on a rat lung air leak model. J Biomed Mater Res 2001;58:658–65. 33. Gika M, Kawamura M, Izumi Y, et al. The short-term efficacy of fibrin glue combined with absorptive sheet material in visceral pleural defect repair. Interact Cardiovasc Thorac Surg 2007;6:12–5.
Comparing treatment with control groups, the sealant group was reported to have shorter duration of air leak 381 382 Rice & Blackstone Table 3 Synthetic sealants: findings in RCTs Reduction in Air Leak Sealant/ First Author Reduction in: Difference in: Chest Tube Hospital Evidence Magnitude Incidence Duration Duration Stay Cost Complications Grade Glutaraldehyde Tansley et al22 NS Polyethylene glycol Macchiarini NS et al23 Porte et al24 Y Wain et al25 NS Allen et al26 NS D’Andrilli et al27 NS Y Y Y Y NS Æ 1B Y Æ Æ Æ Æ Æ 2A Y 4 day Æ 6 day Y Y Y Y NR Æ NS Æ 2B Y Æ Y Æ Æ NR Æ Y Æ NS NS NS Æ Æ Æ 1B 1B 2B Abbreviations: Y, decrease; Æ, no difference; NR, not reported; NS, not studied.
Air Leak after Pulmonary Resection (Thoracic Surgery Clinics of North America, Vol 20, Issue 3 Aug10) by Alessandro Brunelli MD