Histologic changes associated with the use of fibrinogen- and thrombin-impregnated collagen in the prevention of pulmonary air leakage

Abstract

TachoSil provided a mechanical scaffold on which healing could proceed, followed by biodegradation over the long term. TachoSil safely repaired the pleural defects without affecting lung parenchyma.

Efficacy of a Novel Medical Adhesive for Sealing Lung Parenchyma: An in vitro Study in Rabbit Lungs

“…Additional methods, including the application of sealants such as collagen-coated patches, fibrin glue, and other synthetic materials, have been used to minimize air leak severity and duration [6,7]. Sealants based on a fixed combination of a collagen patch coated with human thrombin-fibrinogen sponge-like Ta-choSil ® (Takeda, Osaka, Japan) have also been used [8,9]. However, results from studies comparing TachoSil ® with classical surgical techniques have not demonstrated additional value when using the sealant if airtightness was established with conventional practices [6,8].…”

Addressing a missing point: The short- and long-term effects of a lung sealant patch

“…First, the interrelationships among the different cell lines involved during the reparative process may partially explain the development of PAL in human beings when some regenerative processes fail to occur. According to the results produced by Tsubokawa and associates, 3 the mechanisms responsible for the airtight covering of the lung and the reparation of the pleural defect occur early in the healing process, before POD 7. The mesothelium migrates through the collagen scaffold to cover the outermost layer of the fleece by POD 4, and this supports the clinical observation that most air leaks resolve by this time.…”

“…The article in this issue of the Journal by Tsubokawa and associates 3 addresses this important missing issue. Tsubokawa and associates 3 are to be congratulated for producing a very elegant experimental study that details the dynamic healing mechanisms of a pleural defect when covered by a sealant.…”

Video-assisted thoracoscopic lung cancer lobectomy for patients with incomplete interlobar fissure: is it a safe and reasonable procedure?

“…Despite the effective use of surgical staplers and the "hilum first, fissure last" technique, incomplete interlobar fissures are associated with a risk of damage to visceral pleura and a subsequent probability of a prolonged air leak (1). A prolonged air leak has adverse impacts on morbidity, culminating in a lengthy hospitalization with negative effects and delayed adjuvant treatment (2).…”