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 fresh progresses in surgical strategy and better perioperative care, lengthy air leak continues to be a widespread hassle after pulmonary resection. Articles will handle subject matters akin to the physics and dynamics of the pleural house, probability elements of lengthy air leak, surgical strategies and interoperative measures, using sealants or buttressing fabric; postoperative rescue techniques and postoperative administration of the chest tube, together with using new digitalized platforms 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)
Randomised controlled trial. J Cardiothorac Surg 2009;4:37–42. DeCamp MM, Blackstone EH, Naunheim KS, et al. NETT Research Group. Patient and surgical factors influencing air leak after lung volume reduction surgery: lessons learned from the National Emphysema Treatment Trial. Ann Thorac Surg 2006;82:197–206. Venuta F, Rendina EA, De Giacomo T, et al. Technique to reduce air leaks after pulmonary lobectomy. Eur J Cardiothorac Surg 1998;13:361–4. Miller JI Jr, Landreneau RJ, Wright CE, et al. A comparative study of buttressed versus nonbuttressed staple line in pulmonary resections.
In lung surgery, these complications have not been attributed to collagen fleece–bound fibrin sealants. Recommendations Despite being the most recent experience, studies of collagen fleece–bound fibrin sealants are, to date, the least well conducted and analyzed. Evidence-based literature does not support the routine use of these sealants in pulmonary surgery (see Table 4). 385 buttressing techniques were rapidly adopted with incomplete supporting evidence. Only late in the LVRS experience did some data become available.
Y ? NS ? Æ Æ 2B ? , not yet published; NS, not studied. 015). 07) were similar. In a single-institution study of 152 consecutive patients with an air leak undergoing lobectomy or segmentectomy, Anegg and colleagues36 randomized 75 patients to receive equine collagen fleece coated with human fibrinogen and collagen to all pulmonary surfaces with air leak (treatment) and 77 not (control) (evidence grade 2C). All comparisons were done with t-tests, despite some time-related measures and skewed data, that, combined with inconsistently reported variability, make the analysis difficult to interpret.