Abstract:
Background:Intraoperative alveolar air leak (IOAAL) is one of most common complications after video-assisted thoracoscopic surgery (VATS) lobectomy. The study aimed to evaluate if, in moderate IOAAL, intraoperative polymeric biodegradable sealant (ProgelTM) reduced postoperative air leak (PAL) and consequently was cost-effective. Methods:Patients with moderate IOAAL were randomised in a multicentre trial to intraoperative use of a sealant (Sealant group) or standard management of air leaks (Control group). Primary endpoint was the postoperative duration of air leakage. Secondary outcomes included: time to drainage removal, length of hospital stay, postoperative complications within 2 months, and cost analysis. Results:Between January 2015 and January 2017, 255 VATS lobectomies were performed in four centres. Fifty-five met inclusion criteria and were randomly assigned to Sealant group [28] and Control group [27]. The mean air leakage duration was statistically different between groups (Sealant group =1.60 days, Control group =5.04 days; P<0.001). The average length of drainage was significantly (P=0.008) shorter in Sealant group (4.1 days) than in Controls (6.74 days). The mean time of hospital stay was statistically shorter in sealant group (Sealant =5.75 days, Control =7.85 days; P=0.026). Sealant group observed a statistically significant reduction of costs. Conclusions:In moderate IOAAL after VATS lobectomy, polymeric biodegradable sealants are safe and efficient. Compared with standard treatments, sealant significantly reduces PAL, time to drain removal and length of hospital stay resulting in significant costs benefits.
journal_name
J Thorac Disjournal_title
Journal of thoracic diseaseauthors
Zaraca F,Vaccarili M,Zaccagna G,Maniscalco P,Dolci G,Feil B,Perkmann R,Bertolaccini L,Crisci Rdoi
10.21037/jtd.2017.11.109subject
Has Abstractpub_date
2017-12-01 00:00:00pages
5230-5238issue
12eissn
2072-1439issn
2077-6624pii
jtd-09-12-5230journal_volume
9pub_type
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pub_type: 杂志文章
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更新日期:2018-12-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2018-08-01 00:00:00
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journal_title:Journal of thoracic disease
pub_type: 已发布勘误
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pub_type: 杂志文章,评审
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更新日期:2014-10-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2014-10-01 00:00:00
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pub_type: 杂志文章
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