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Interlobar fixation using TachoSil(®): a novel technique.

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Published:1st Oct 2015
Author: Fiorelli A, Scaramuzzi R, Costanzo S, Volpicelli A, Santini M.
Availability: Free full text
Ref.:Transl Lung Cancer Res. 2015 Oct;4(5):605-9.
DOI:10.3978/j.issn.2218-6751.2015.10.02.
Interlobar fixation using TachoSil®: a novel technique


Background:
We evaluated the use of TachoSil(®) for anchoring middle lobe to lower lobe after upper right lobectomy.

Methods: The fixation of middle lobe to lower lobe was required in 39/213 consecutive upper lobectomies. In 19/39 (49%) cases, it was performed with suturing and/or stapler (standard group) and in 20 cases (TachoSil group) with Tachosil(®) alone.

Results: The operative time, complications, length of chest drain and hospital stay were similar between two groups. However, standard compared to TachoSil(®) group presented a higher incidence of atelectasis (5% vs. 0%, P=0.4) and air leaks (5% vs. 0%, P=0.4) but it did not reach significant difference. Our technique was safe, easy, and quick.

Conclusions: Upon contact with pleura, the clotting factors of TachoSil(®) dissolved and formed a fibrin network which glued the collagen sponge to the pleura surface. It allowed to fix the middle lobe to lower lobe without restricting lung re-expansion and/or injuring the parenchyma.


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