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Ann Thorac Surg 2004;77:1792-1801
© 2004 The Society of Thoracic Surgeons
a Division of General Thoracic Surgery, Mayo Clinic, Rochester, Minnesota, USA
b Division of Cardiothoracic Surgery, University of Washington, Seattle, Washington, 3M Corporation, St. Paul, Minnesota, Duke University Medical Center, Durham, North Carolina, Cedars Sinai Medical Center, Los Angeles, California, and M.D. Anderson Cancer Center, Houston, Texas, USA
Accepted for publication October 10, 2003.
* Address reprint requests to Dr Allen, Division of General Thoracic Surgery, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA
e-mail: allen.mark{at}mayo.edu
Presented at the Thirty-ninth Annual Meeting of The Society of Thoracic Surgeons, San Diego, CA, Jan 31–Feb 2, 2003.
BACKGROUND: To evaluate the safety and effectiveness of a new biodegradable polymeric sealant to close intraoperative air leaks after pulmonary resection.
METHODS: In a multicenter prospective randomized trial, 161 patients with a median age of 67 years old (range 18–85 years old), were randomized in a 2:1 ratio to receive sealant or control for at least one significant air leak (
2.0 mm in size) after pulmonary resection. In the sealant group, all significant air leaks underwent attempted repair by standard methods (sutures, staples, or cautery) prior to the application of sealant. The control group underwent only standard methods. Blood was analyzed for immunologic response. Patients were followed up 1 month after surgery.
RESULTS: Intraoperative air leaks were sealed in 77% of the sealant group compared with 16% in the control group (p < 0.001). The sealant group had significantly fewer patients with postoperative air leaks compared with the control group (65% vs 86%, p = 0.005). Median length of hospitalization was 6 days (range, 3–23 days) for the sealant group compared with 7 days (range 4–38 days) for controls (p = 0.028). There was no difference in mortality, morbidity, duration of chest tubes, or immune responses between the two groups.
CONCLUSIONS: This study demonstrates the effectiveness of a biodegradable polymer when used as an adjunct to standard closure methods for sealing significant intraoperative air leaks that develop from pulmonary surgery. Use of the sealant led to a reduction in postoperative air leaks, which may have decreased the length of hospitalization.
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