Rathinam, Sridhar, Naidu, Babu V., Nanjaiah, Prakash, Loubani, Mahmoud, Kalkat, Maninder S. and Rajesh, Pala Babu. (2009) BioGlue and Peri-strips in lung volume reduction surgery : pilot randomised controlled trial. Journal of Cardiothoracic Surgery, Vol.4 (No.1). p. 37. ISSN 1749-8090

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Abstract

Background Both tissue sealants and buttressing have been advocated to reduce alveolar air leaks from staple lines following Lung Volume Reduction Surgery (LVRS). However, the long term detrimental effects of buttressing material are increasingly apparent. We performed a pilot prospective randomised self controlled trial in patients undergoing LVRS comparing BioGlue and Peri-strips as adjuncts in preventing alveolar air-leaks. Methods A pilot prospective self controlled clinical trial was conducted in patients undergoing LVRS. Each patient was treated with BioGlue on one side and pericardial buttress on the other side as an adjunct to the staple line. The sides were randomised for adjuncts with each patient acting as his own control. Duration of air leak, intercostal drainage and time to chest drain removal were the study end points. Results 10 patients undergoing the procedure were recruited between December 2005 and October 2007. There were 6 men and the mean age was 59.8 ± 4.9 years. There was one mortality due to multi-organ failure. The BioGlue treated side had a shorter mean duration of air-leak (3.0 ± 4.6 versus 6.5 ± 6.9 days), lesser chest drainage volume (733 ± 404 ml versus 1001 ± 861) and shorter time to chest drain removal (9.7 ± 10.6 versus 11.5 ± 11.1 days) compared with Peri-strips. Conclusion This study demonstrates comparable efficacy of BioGlue and Peri-strips, however there is a trend favouring the BioGlue treated side in terms of reduction in air-leak, chest drainage volumes, duration of chest drainage and significant absence of complications. A larger sample size is needed to validate this result.

Item Type:	Journal Article
Subjects:	R Medicine > RD Surgery
Divisions:	Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Lungs -- Surgery, Adhesives in surgery
Journal or Publication Title:	Journal of Cardiothoracic Surgery
Publisher:	BioMed Central Ltd.
ISSN:	1749-8090
Date:	17 July 2009
Volume:	Vol.4
Number:	No.1
Page Range:	p. 37
Identification Number:	10.1186/1749-8090-4-37
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access
Funder:	Cryolife Europa
References:	1. Cooper JD, Trulock EP, Triantafillou AN, Patterson GA, Pohl MS, Deloney PA, Sundaresan RS, Roper CL: Bilateral pneumectomy (volume reduction) for chronic obstructive pulmonary disease. J Thorac Cardiovasc Surg 1995, 109:106-116. 2. Fishman A, Martinez F, Naunheim K, Piantadosi S, Wise R, Ries A, Weinmann G, Wood DE: A randomized trial comparing lungvolume- reduction surgery with medical therapy for severe emphysema. N Engl J Med 2003, 348:2059-2073. 3. DeCamp MM, Blackstone EH, Naunheim KS, Krasna MJ, Wood DE, Meli YM, McKenna RJ Jr: 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. 4. Geddes D, Davies M, Koyama H, Hansell D, Pastorino U, Pepper J, Agent P, Cullinan P, MacNeill SJ, Goldstraw P: Effect of lung-volume- reduction surgery in patients with severe emphysema. N Engl J Med 2000, 343:239-245. 5. Cooper JD: Technique to reduce air leaks after resection of emphysematous lung. Ann Thorac Surg 1994, 57:1038-1039. 6. Stammberger U, Klepetko W, Stamatis G, Hamacher J, Schmid RA, Wisser W, Hillerjan L, Weder W: Buttressing the staple line in lung volume reduction surgery: a randomized three-center study. Ann Thorac Surg 2000, 70:1820-1825. 7. Porte HL, Jany t, Akkad R, Conti M, Gillet PA, Guidat A, Wurtz AJ: Randomized controlled trial of a synthetic sealent for preventing alveolar airleaks after lobectomy. Ann Thorac Surg 2001, 71:1618-1622. 8. Serra-Mitjans M, Belda-Sanchis J, Rami-Porta R: Surgical sealent for preventing air leaks after pulmonary resections in patients with lung cancer update of Cochrane Database Syst Rev 2001. Cochrane Database Syst Rev 2005. 9. Tansley P, Al-Mulhim F, Lim E, Ladas G, Goldstraw P: A prospective, randomized, controlled trial of the effectiveness of BioGlue in treating alveolar air leaks. J Thorac Cardiovasc Surg 2006, 132:105-112. 10. Cooper JD, Trulock EP, Triantafillou AN, Patterson GA, Pohl MS, Deloney PA, Sundaresan RS, Roper CL: Trial of a novel synthetic sealent in preventing air leaks after lung resection. Ann Thorac Surg. 2000, 71(5):1623-1628. 11. Brantigan OC, Mueller E: Surgical treatment of pulmonary emphysema. Am Surg 1957, 23:789-804. 12. McKenna RJ Jr, Benditt JO, DeCamp M, Deschamps C, Kaiser L, Lee SM, Mohsenifar Z, Piantadosi S, Ramsey S, Reilly J, Utz J: Safety and efficacy of median sternotomy versus video-assisted thoracic surgery for lung volume reduction surgery. J Thorac Cardiovasc Surg 2004, 127:1350-1360. 13. Snell GI, Solin P, Chin W, Rabinov M, Williams TJ, Esmore DS, Smith JA: Lung volume reduction surgery for emphysema. Med J Aust 1997, 167:529-532. 14. Weder W, Schmid RA, Russi EW: Thoracoscopic lung volume reduction surgery for emphysema. Int Surg 1996, 81:229-234. 15. Naunheim KS, Wood DE, Mohsenifar Z, Sternberg AL, Criner GJ, DeCamp MM, Deschamps CC, Martinez FJ, Sciurba FC, Tonascia J, Fishman AP: Long-term follow-up of patients receiving lungvolume- reduction surgery versus medical therapy for severe emphysema by the National Emphysema Treatment Trial Research Group. Ann Thorac Surg 2006, 82:431-443. 16. Iwasaki A, Yoshinaga Y, Shirakusa T: Successful removal of bovine pericardium by bronchoscope after lung volume reduction surgery. Ann Thorac Surg 2004, 78:2156-2157. 17. Provencher S, Deslauriers J: Late complication of bovine pericardium patches used for lung volume reduction surgery. Eur J Cardiothorac Surg 2003, 23:1059-1061. 18. Oey I, Waller DA: Metalloptysis: a late complication of lung volume reduction surgery. Ann Thorac Surg 2001, 71:1694-1695. 19. Shamji MF, Maziak DE, Shamji FM, Matzinger FR, Perkins DG: Surgical staple metalloptysis after apical bullectomy: a reaction to bovine pericardium? Ann Thorac Surg 2002, 74:258-261. 20. Potaris K, Mihos P, Gakidis I: Preliminary results with the use of an albumin-glutaraldehyde tissue adhesive in lung surgery. Med Sci Monit. 2003, 9(7):PI79-PI83.
URI:	http://wrap.warwick.ac.uk/id/eprint/42440

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