A series of experiences with TissuePatch™ for alveolar air leak after pulmonary resection

Gen Thorac Cardiovasc Surg. 2023 Oct;71(10):570-576. doi: 10.1007/s11748-023-01921-y. Epub 2023 Mar 5.

Abstract

Objectives: Prolonged air leak after pulmonary resection strongly influences chest tube duration and hospitalization. This prospective study aimed to report a series of experiences with a synthetic sealant (TissuePatch™) and compare them with a combination covering method (polyglycolic acid sheet + fibrin glue) for air leaks after pulmonary surgery.

Methods: We included 51 patients (age: 20-89 years) who underwent lung resection. Patients who presented with alveolar air leak during the intraoperative water sealing test were randomly assigned to the TissuePatch™ or combination covering method groups. The chest tube was removed when there was no air leak over a period of 6 h, and no active bleeding under continuous monitoring using a digital drainage system. The chest tube duration was assessed, and various perioperative factors (such as the index of prolonged air leak score) were evaluated.

Results: Twenty (39.2%) patients developed intraoperative air leak; ten patients received TissuePatch™; and one patient who was receiving TissuePatch™ switched to the combination covering method because of broken TissuePatch™. The chest tube duration, index of prolonged air leak score, prolonged air leak, other complications, and postoperative hospitalization in both groups were similar. No TissuePatch™-related adverse events were reported.

Conclusions: Results from the use of TissuePatch™ were almost similar to those associated with the use of combination covering method in preventing prolonged postoperative air leak after pulmonary resection. Randomized, double-arm studies are required to confirm the efficacy of TissuePatch™ observed during this study.

Keywords: Air leak; Lung resection; Thoracic surgery; Video-assisted thoracoscopic surgery; Water sealing test.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chest Tubes / adverse effects
  • Drainage / adverse effects
  • Fibrin Tissue Adhesive / therapeutic use
  • Humans
  • Middle Aged
  • Pneumonectomy* / adverse effects
  • Pneumonectomy* / methods
  • Postoperative Complications* / etiology
  • Prospective Studies
  • Young Adult

Substances

  • Fibrin Tissue Adhesive