Bronchial Stump Coverage with Fibrin Glue-Coated Collagen Fleece in Lung Cancer Patients Who Underwent Pneumonectomy

Seok, Yangki; Cho, Sukki; Lee, Eungbae

doi:10.5761/atcs.oa.12.02166

Cited by 6 publications

(13 citation statements)

References 16 publications

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“…On the basis of NT, Hu et al (31) even designed an effective clinical risk model to evaluate the development of BPF. However, the significant relationship between NT and risk of BPF was not shown in most of the included studies (21,(24)(25)(26)(27)(28)(29)(30)32,(34)(35)(36)(37)(38)(39)(40)44,(46)(47)(48), including the currently largest study which enrolled 6239 surgical patients from China (35). Refai et al (44) proposed that adequately balanced comparison should be a prerequisite to demonstrate the impact of NT on surgical outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Considering the NT strategies, there were six studies (22,25,30,31,36,43) excluded because no relevant detail of NT was reported in these studies. Pooled analyses suggested that NR (OR: 3.914; 95%CI: 1.401-10.935; P = 0.009) (23,46,48,50) and NCR (OR: 2.533; 95%CI: 1.353-4.741; P = 0.004) (24,(27)(28)(29)32,33,(39)(40)(41)44,49) were both significantly associated with the increased risk of BPF, with low heterogeneity (Table 3 and Fig. 3B).…”

Section: Subgroup Analysismentioning

confidence: 99%

“…Asian patients provided 77.2% of the enrolled samples (11 510/14 912) (23,30,31,34,35,40,42,45,46,49,50), including 6923 cases from China (31,35), 4347 cases from Japan (23,30,34,40,42,49,50), 177 cases from Turkey (45) and 63 cases from Korea (46). The other 3402 patients (3402/14 912, ratio = 22.8%) were from European and North American countries and reported in 19 studies (21,22,(24)(25)(26)(27)(28)(29)32,33,(36)(37)(38)(39)41,43,44,47,48).…”

Section: The Basic Characteristics Of Included Studiesmentioning

confidence: 99%

“…Thirteen included studies (21,24,(26)(27)(28)(29)32,(37)(38)(39)41,44,45) analyzed the differences in BPF development between the patients undergoing NT followed by operations and those undergoing operations alone (NT + surgery vs. surgery alone) ( Table 2). The other 17 included studies (22,23,25,30,31,(33)(34)(35)(36)40,42,43,(46)(47)(48)(49)(50) classified 12 919 patients (12 919/14 912, ratio = 86.6%) by BPF occurrence, and evaluated the risk factors of BPF based on the patients with BPF and without BPF (BPF vs. non-BPF) ( Table 2). Furthermore, more than half of these 17 studies (22,23,30,31,35,40,42,43,47) performed both univariate analysis and multivariate analysis to comprehensively identify the independent factors of BPF.…”

Section: The Statistical Characteristics Of Included Studiesmentioning

confidence: 99%

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Neoadjuvant therapy and risk of bronchopleural fistula after lung cancer surgery: a systematic meta-analysis of 14 912 patients

Fan

Liu

et al. 2016

Jpn. J. Clin. Oncol.

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Objective: Neoadjuvant therapy has been extensively analyzed in studies addressing the risk factors of bronchopleural fistula, but their results vary hugely. Therefore, we conducted this meta-analysis to determine the association between neoadjuvant therapy and risk of bronchopleural fistula in patients undergoing lung cancer surgery. Methods: We searched PubMed and EMBASE to identify the full-text literatures that met our eligibility criteria. Odds ratio with 95% confidence interval served as the summarized statistics. Heterogeneity within this meta-analysis was evaluated by Q-test and I 2 statistic. Sensitivity analysis was performed for further assessments of robustness. Publication bias was detected by Begg's test and Egger's test.Results: Thirty studies enrolling 14 912 lung cancer cases were included into this meta-analysis. The incidence of bronchopleural fistula was 2.4% (354/14 912) in the large scale. Overall, neoadjuvant therapy significantly increased the risk of bronchopleural fistula after pulmonary resections (odds ratio: 2.166; 95% confidence interval: 1.398-3.357; P = 0.001). In subgroup analysis, neoadjuvant radiotherapy (odds ratio: 3.914; 95% confidence interval: 1.401-10.935; P = 0.009) and chemo-radiation (odds ratio: 2.533; 95% confidence interval: 1.353-4.741; P = 0.004) were significantly associated with the bronchopleural fistula risk but neoadjuvant chemotherapy was not (odds ratio: 1.857; 95% confidence interval: 0.881-3.911; P = 0.104). The impact of neoadjuvant therapy on bronchopleural fistula occurrence remains statistically prominent in the other subgroups. Conclusions: Neoadjuvant therapy is significantly associated with the occurrence of bronchopleural fistula after lung cancer surgery. Both neoadjuvant radiotherapy and chemo-radiation significantly increase the bronchopleural fistula risk but neoadjuvant chemotherapy does not. Some limitations still exist in this meta-analysis. The updated high-quality studies can help to further confirm and enrich our discoveries in the future.

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Section: Discussionmentioning

confidence: 99%

Section: Subgroup Analysismentioning

confidence: 99%

Section: The Basic Characteristics Of Included Studiesmentioning

confidence: 99%

Section: The Statistical Characteristics Of Included Studiesmentioning

confidence: 99%

See 2 more Smart Citations

Neoadjuvant therapy and risk of bronchopleural fistula after lung cancer surgery: a systematic meta-analysis of 14 912 patients

Fan

Liu

et al. 2016

Jpn. J. Clin. Oncol.

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“…Therefore, the bronchial stump is reinforced intraoperatively with various dressings to prevent BPF development. Methods used to cover the bronchial stump include patching with a polyglycolic acid sheet, spraying fibrin glue, patching the fibrin glue‐coated collagen fleece, and suturing pericardial fat tissue . A pedicled intercostal muscle flap (IMF) is used as the covering material for high‐risk cases of BPF .…”

Section: Introductionmentioning

confidence: 99%

Indocyanine green fluorescence/thermography evaluation of intercostal muscle flap vascularization

et al. 2018

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BackgroundDuring anatomical lung resection in high‐risk patients, the bronchial stump is covered with tissue flaps (e.g. pericardial fat tissue and intercostal muscle) to prevent bronchopleural fistula development. This is vital for reliable reinforcement of the bronchial stump. We evaluated the blood supply of the flap using indocyanine green fluorescence (ICG‐FL) and thermography intraoperatively in 27 patients at high risk for developing a bronchopleural fistula.MethodsBefore reinforcing the stump with a flap, the fluorescence agent was intravenously injected and the blood supply was evaluated. The surface temperature of the flap was measured with thermography. The two modalities were then compared.ResultsICG‐FL intensity and surface temperature on the distal compared to the proximal side of the flap decreased by 32.6 ± 29.4% (P < 0.0001) and 3.5 ± 2.0°C (P < 0.0001), respectively. In patients with a higher ICG‐FL intensity value at the tip than the median, the surface temperature at the tip decreased by 2.7 ± 1.7°C compared to the proximal side. In patients with a lower ICG‐FL value at the tip, the surface temperature decreased by 4.6 ± 1.7°C (P = 0.0574). The bronchial stump reinforced the part of the flap with adequate blood supply; none of the patients developed a bronchopleural fistula.ConclusionsICG‐FL confirmed variation in the blood supply of the intercostal muscle flap, even if prepared using the same surgical procedure. Thermography analysis tends to correlate with the fluorescence method, but may be influenced by the state of flap preservation during surgery.

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Investigation of surgical technique for bronchial stump closure after lobectomy in animal model

Makidono

Miyata

Ikeda

et al. 2019

Gen Thorac Cardiovasc Surg

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Bronchial Stump Coverage with Fibrin Glue-Coated Collagen Fleece in Lung Cancer Patients Who Underwent Pneumonectomy

Cited by 6 publications

References 16 publications

Neoadjuvant therapy and risk of bronchopleural fistula after lung cancer surgery: a systematic meta-analysis of 14 912 patients

Neoadjuvant therapy and risk of bronchopleural fistula after lung cancer surgery: a systematic meta-analysis of 14 912 patients

Indocyanine green fluorescence/thermography evaluation of intercostal muscle flap vascularization

Investigation of surgical technique for bronchial stump closure after lobectomy in animal model

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