Document Detail


Air-leak management after upper lobectomy in patients with fused fissure and chronic obstructive pulmonary disease: a pilot trial comparing sealant and standard treatment.
MedLine Citation:
PMID:  19776082     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A pilot trial to compare the efficacy of two different procedures to prevent postoperative air-leak in chronic obstructive pulmonary disease (COPD) patients submitted to upper lobectomy for non-small cell lung cancer. Sixty patients with COPD and lung cancer at the upper pulmonary lobes eligible for lobectomy were enrolled and randomly assigned either to standard treatment (ST) with stapling device or to electrocautery dissection and application of a collagen patch coated with human fibrinogen and thrombin (TachoSil) (experimental treatment [ET]) for the intra-operative completion of their fused fissures. Thirty patients were enrolled in each group during a three-year period. Preoperative characteristics were similar between the two groups. Statistically significant reduction of air-leak was registered in the ET group when overall incidence of postoperative air-leak (55% vs. 96%; P=0.03), postoperative air-leak (mean 1.63+/-1.96 vs. 4.33+/-4.12 days; P=0.0018), chest-drain (mean 3.53+/-1.59 vs. 5.90+/-3.72 days; P=0.0021) and hospital stay duration (mean 5.87+/-1.07 vs. 7.50+/-3.20 days; P=0.01) were considered. The use of TachoSil to prevent postoperative air-leak after interlobar fissure completion in patients with COPD submitted to upper lobectomy seems to be safe and more effective than the ST based on stapling device application.
Authors:
Ottavio Rena; Esther Papalia; Tommaso Claudio Mineo; Fabio Massera; Emanuele Pirondini; Davide Turello; Caterina Casadio
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2009-09-23
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  9     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-20     Completed Date:  2010-01-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  973-7     Citation Subset:  IM    
Affiliation:
Thoracic Surgery Unit, University of Eastern Piedmont A. Avogadro, Via Frasconi, 14, 28100 Novara, Italy. ottaviorena@libero.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Carcinoma, Non-Small-Cell Lung / complications,  surgery*
Combined Modality Therapy
Drainage
Drug Combinations
Electrocoagulation*
Female
Fibrinogen / therapeutic use*
Humans
Length of Stay
Lung Neoplasms / complications,  surgery*
Male
Middle Aged
Pilot Projects
Pneumonectomy / adverse effects*
Postoperative Complications / prevention & control*
Prospective Studies
Pulmonary Disease, Chronic Obstructive / complications*
Surgical Stapling*
Thrombin / therapeutic use*
Tissue Adhesives / therapeutic use*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Drug Combinations; 0/TachoSil; 0/Tissue Adhesives; 9001-32-5/Fibrinogen; EC 3.4.21.5/Thrombin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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