HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Paolo Macchiarini John Wain Philippe Dartevelle Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Macchiarini, P. Articles by Dartevelle, P. Search for Related Content PubMed PubMed Citation Articles by Macchiarini, P. Articles by Dartevelle, P.

J Thorac Cardiovasc Surg 1999;117:751-758
© 1999 Mosby, Inc.

GENERAL THORACIC SURGERY

EXPERIMENTAL AND CLINICAL EVALUATION OF A NEW SYNTHETIC, ABSORBABLE SEALANT TO REDUCE AIR LEAKS IN THORACIC OPERATIONS

From the Departments of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie-Lannelongue Hôpital, Paris-Sud University, Le Plessis Robinson, France^a; Thoracic Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, Mass^b; and Statistics Unlimited, Inc, Westford, Mass.^c

Received for publication July 24, 1998. Revisions requested Oct 30, 1998. Revisions received Nov 23, 1998. Accepted for publication Nov 23, 1998. Address for reprints: Paolo Macchiarini, MD, PhD, Department of Thoracic and Vascular Surgery, Heidehaus Hospital (Hannover Medical School), 70, Leineufer, D-30419, Hannover, Germany.

Background: Air leaks after pulmonary resections may contribute to increased patient morbidity, delayed removal of chest drainage tubes, and prolonged hospitalization. Objective: The purpose of this study was to investigate the effects of a new synthetic, absorbable sealant on the healing of healthy bronchial and lung tissues (experimental study) and its safety and efficacy to stop air leaks after lung resection (clinical study).
Methods: Fifteen large white pigs underwent a left upper lobectomy. All parenchymal surgical sites were sealed; the bronchial stump was either stapled, sealed, or both (n = 5 each). In the clinical study, 26 consecutive patients were prospectively randomized, intraoperatively, to standard closure of parenchymal surgical sites with (n = 15) or without (n = 11) the sealant.
Results: In the experimental study, no postoperative air leaks occurred, with intact bronchial closures and normal tissues at death. In the clinical study, 100% of intraoperative leaks were sealed versus 18% of control patients (P = .001). Although 77% (n = 10) of treated patients remained leak-free from the end of the operation to chest tube removal versus 9% (n = 1) of control patients (P = .001), there was no statistical difference in the duration of postoperative chest tube time, hospital stay, or cost. There were no acute or late undesirable side-effects related to the sealant application.
Conclusions: The surgical adhesive investigated here demonstrated a compelling safety profile and significant clinical efficacy to stop air leaks after lung resections.

This article has been cited by other articles:

				O. Rena, E. Papalia, T. C. Mineo, F. Massera, E. Pirondini, D. Turello, and C. Casadio Air-leak management after upper lobectomy in patients with fused fissure and chronic obstructive pulmonary disease: a pilot trial comparing sealant and standard treatment Interactive CardioVascular and Thoracic Surgery, December 1, 2009; 9(6): 973 - 977. [Abstract] [Full Text] [PDF]

				G. Cardillo, F. Carleo, L. Carbone, M. Di Martino, L. Salvadori, L. Petrella, and M. Martelli Chronic postpneumonic pleural empyema: comparative merits of thoracoscopic versus open decortication Eur. J. Cardiothorac. Surg., November 1, 2009; 36(5): 914 - 918. [Abstract] [Full Text] [PDF]

				A. D'Andrilli, C. Andreetti, M. Ibrahim, A. M. Ciccone, F. Venuta, U. Mansmann, and E. A. Rendina A prospective randomized study to assess the efficacy of a surgical sealant to treat air leaks in lung surgery Eur. J. Cardiothorac. Surg., May 1, 2009; 35(5): 817 - 821. [Abstract] [Full Text] [PDF]

				M. Kanzaki, M. Yamato, J. Yang, H. Sekine, R. Takagi, T. Isaka, T. Okano, and T. Onuki Functional closure of visceral pleural defects by autologous tissue engineered cell sheets Eur. J. Cardiothorac. Surg., October 1, 2008; 34(4): 864 - 869. [Abstract] [Full Text] [PDF]

				C. Moser, I. Opitz, W. Zhai, V. Rousson, E.W. Russi, W. Weder, and D. Lardinois Autologous fibrin sealant reduces the incidence of prolonged air leak and duration of chest tube drainage after lung volume reduction surgery: a prospective randomized blinded study. J. Thorac. Cardiovasc. Surg., October 1, 2008; 136(4): 843 - 849. [Abstract] [Full Text] [PDF]

				A. Droghetti, A. Schiavini, P. Muriana, A. Folloni, M. Picarone, C. Bonadiman, C. Sturani, R. Paladini, and G. Muriana A prospective randomized trial comparing completion technique of fissures for lobectomy: stapler versus precision dissection and sealant. J. Thorac. Cardiovasc. Surg., August 1, 2008; 136(2): 383 - 391. [Abstract] [Full Text] [PDF]

				U. Anegg, R. Rychlik, and F. Smolle-Juttner Do the benefits of shorter hospital stay associated with the use of fleece-bound sealing outweigh the cost of the materials? Interactive CardioVascular and Thoracic Surgery, April 1, 2008; 7(2): 292 - 296. [Abstract] [Full Text] [PDF]

				M. Araki, H. Tao, N. Nakajima, H. Sugai, T. Sato, S.-H. Hyon, T. Nagayasu, and T. Nakamura Development of new biodegradable hydrogel glue for preventing alveolar air leakage. J. Thorac. Cardiovasc. Surg., November 1, 2007; 134(5): 1241 - 1248. [Abstract] [Full Text] [PDF]

				J. Tambiah, R. Rawlins, D. Robb, and T. Treasure Can tissue adhesives and glues significantly reduce the incidence and length of postoperative air leaks in patients having lung resections? Interactive CardioVascular and Thoracic Surgery, August 1, 2007; 6(4): 529 - 533. [Abstract] [Full Text] [PDF]

				M. Araki, H. Tao, T. Sato, N. Nakajima, H. Sugai, S.-H. Hyon, T. Nagayasu, and T. Nakamura Creation of a uniform pleural defect model for the study of lung sealants J. Thorac. Cardiovasc. Surg., July 1, 2007; 134(1): 145 - 151. [Abstract] [Full Text] [PDF]

				U. Anegg, J. Lindenmann, V. Matzi, J. Smolle, A. Maier, and F. Smolle-Juttner Efficiency of fleece-bound sealing (TachoSil(R)) of air leaks in lung surgery: a prospective randomised trial Eur. J. Cardiothorac. Surg., February 1, 2007; 31(2): 198 - 202. [Abstract] [Full Text] [PDF]

				M. Gika, M. Kawamura, Y. Izumi, and K. Kobayashi The short-term efficacy of fibrin glue combined with absorptive sheet material in visceral pleural defect repair Interactive CardioVascular and Thoracic Surgery, February 1, 2007; 6(1): 12 - 15. [Abstract] [Full Text] [PDF]

				M. J. Shackcloth, M. Poullis, M. Jackson, A. Soorae, and R. D. Page Intrapleural instillation of autologous blood in the treatment of prolonged air leak after lobectomy: a prospective randomized controlled trial. Ann. Thorac. Surg., September 1, 2006; 82(3): 1052 - 1056. [Abstract] [Full Text] [PDF]

				P. Tansley, F. Al-Mulhim, E. Lim, G. Ladas, and P. Goldstraw A prospective, randomized, controlled trial of the effectiveness of BioGlue in treating alveolar air leaks J. Thorac. Cardiovasc. Surg., July 1, 2006; 132(1): 105 - 112. [Abstract] [Full Text] [PDF]

				P. Thomas, G. Massard, H. Porte, C. Doddoli, X. Ducrocq, and M. Conti A new bioabsorbable sleeve for lung staple-line reinforcement (FOREsealtrade mark): report of a three-center phase II clinical trial. Eur. J. Cardiothorac. Surg., June 1, 2006; 29(6): 880 - 885. [Abstract] [Full Text] [PDF]

				M. Kawamura, M. Gika, Y. Izumi, H. Horinouchi, N. Shinya, M. Mukai, and K. Kobayashi The sealing effect of fibrin glue against alveolar air leakage evaluated up to 48h; comparison between different methods of application Eur. J. Cardiothorac. Surg., July 1, 2005; 28(1): 39 - 42. [Abstract] [Full Text] [PDF]

				G. Varela, M. F. Jimenez, N. Novoa, and J. L. Aranda Estimating hospital costs attributable to prolonged air leak in pulmonary lobectomy Eur. J. Cardiothorac. Surg., February 1, 2005; 27(2): 329 - 333. [Abstract] [Full Text] [PDF]

				A. Brunelli, M. Monteverde, A. Borri, M. Salati, R. D. Marasco, and A. Fianchini Predictors of prolonged air leak after pulmonary lobectomy Ann. Thorac. Surg., April 1, 2004; 77(4): 1205 - 1210. [Abstract] [Full Text] [PDF]

				G. Lang, A. Csekeo, G. Stamatis, L. Lampl, L. Hagman, G. M. Marta, M. R. Mueller, and W. Klepetko Efficacy and safety of topical application of human fibrinogen/thrombin-coated collagen patch (TachoComb) for treatment of air leakage after standard lobectomy Eur. J. Cardiothorac. Surg., February 1, 2004; 25(2): 160 - 166. [Abstract] [Full Text] [PDF]

				T. Fabian, J. A. Federico, and R. B. Ponn Fibrin glue in pulmonary resection: a prospective, randomized, blinded study Ann. Thorac. Surg., May 1, 2003; 75(5): 1587 - 1592. [Abstract] [Full Text] [PDF]

				H. L. Porte, T. Jany, R. Akkad, M. Conti, P. A. Gillet, A. Guidat, and A. J. Wurtz Randomized controlled trial of a synthetic sealant for preventing alveolar air leaks after lobectomy Ann. Thorac. Surg., May 1, 2001; 71(5): 1618 - 1622. [Abstract] [Full Text] [PDF]

				J. C. Wain, L. R. Kaiser, D. W. Johnstone, S. C. Yang, C. D. Wright, J. S. Friedberg, R. H. Feins, R. F. Heitmiller, D. J. Mathisen, and M. R. Selwyn Trial of a novel synthetic sealant in preventing air leaks after lung resection Ann. Thorac. Surg., May 1, 2001; 71(5): 1623 - 1629. [Abstract] [Full Text] [PDF]