Efficacy of an absorbable polyglycolic acid patch in surgery for pneumothorax due to silicosis

Xiao-Ming Lin, Yu Liu, Chuang Chi, Chao-Xi Lin, Yi Yang, Xiao-Ming Lin, Yu Liu, Chuang Chi, Chao-Xi Lin, Yi Yang

Abstract

Background: We conducted a retrospective study to evaluate the efficacy and safety of an absorbable polyglycolic acid (PGA) patch in surgery for refractory pneumothorax due to silicosis.

Methods: A retrospective analysis was performed of 56 patients who received thoracotomy or thoracoscopic surgery for refractory pneumothorax due to silicosis between 1995 and 2010. An absorbable PGA patch was used as a reinforcement or repair material after resection of the bulla in 24 operations and it was not used in another 32 operations. Clinical outcomes were compared between the two groups (with a PGA and without a PGA).

Results: We found that the duration of postoperative chest drainage (5.04±1.12 days vs. 8.19±1.60 days, p<0.01) and hospital stay after the operation (8.33±1.34 days vs. 11.56±1.50 days, p<0.01) were significantly shorter in patients who used an absorbable PGA patch in the operation compared with those who did not use a PGA patch. The incidence of initial air leakage (58.3% [14/24] vs. 93.8% [30/32], p<0.05) and relapse rate of pneumothorax in 6 months (4% [1/24] vs. 25% [8/32], p<0.05) were also significantly lower in patients who used an absorbable PGA patch in the operation compared with those who did not use a PGA patch. No related adverse effects of the absorbable PGA patch occurred after the operations.

Conclusions: Use of an absorbable PGA patch as a reinforcement or repair material in surgery for refractory pneumothorax due to silicosis can reduce postoperative air leakage and improve clinical outcome.

Figures

Figure 1
Figure 1
Resected lung bullae with an endoscopic linear cutter, which buttressed with a sleeve-shaped PGA.
Figure 2
Figure 2
Resected lung bullae with an endoscopic linear cutter, which buttressed with a sleeve-shaped PGA.
Figure 3
Figure 3
Resected lung bullae with an endoscopic linear cutter, which buttressed with a sleeve-shaped PGA.
Figure 4
Figure 4
The basilar part of the bullae was too wide after being resected, then used lamellar PGA and fibrin glue to repair the pleural defect.
Figure 5
Figure 5
The basilar part of the bullae was too wide after being resected, then used lamellar PGA and fibrin glue to repair the pleural defect.

References

    1. Murray KD, Ho CH, Hsia TY. et al.The influence of pulmonary staple line reinforcement on air leaks. Chest. 2002;122:2146–2149. doi: 10.1378/chest.122.6.2146.
    1. Stammberger U, Klepetkow, Stamatis G. et al.Buttressing the staple line in lung volume reductiong surgery: a randomized three center study. Ann Thorae Surg. 2000;70:1820–1825. doi: 10.1016/S0003-4975(00)01903-2.
    1. Saito Y, Minami K, Kobayashi M. et al.New tubular bioabsorbable knitted airway stent biocompatibility and mechanical strength. J Thorac Cardiovasc Surg. 2002;123:161–167. doi: 10.1067/mtc.2002.118503.
    1. Matsumura Y, Okada Y, Shimada K, Endo C, Chida M, Sakurada A, Sato M, Kondo T. New surgical technique of pulmonary segmentectomy by ultrasonic scalpel and absorbable sealing materials. Kyobu Geka. 2004;57:31–37.
    1. Tansley P, Al Mulhim F, Lim E. et al.A prospective, randomized controlled trial of the effectiveness of the Bioglue in treating alveolar air leaks. J Thorac Cardiovasc Surg. 2006;132:105–122. doi: 10.1016/j.jtcvs.2006.02.022.

Source: PubMed

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