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Editorial comment

Pleural tears: are all holes the same?

Department of Thoracic and Vascular Surgery, Antwerp University Hospital, Wilrijkstraat 10, B-2650 Edegem (Antwerp), Belgium

^_* Corresponding author. Tel.: +32 3 8214360; fax: +32 3 8214396. (Email: paul.van.schil@uza.be).

Key Words: Pleura • Repair • Polyglycolic acid • Fibrin sealant • Air leak • CABG • Thoracic surgery

The first 20% of the full text of this article appears below.

Pleural tears are a common occurrence in thoracic surgery and a prolonged air leak is often encountered in patients undergoing lung resection or volume reduction when there is associated emphysema [1]. Spontaneous pneumothorax is closely related to pulmonary blebs and interstitial emphysema resulting in variable collapse of lung tissue [2]. Various sealants and glues are available to repair the pleural defects but the optimal treatment and equally, the management of chest tubes are a matter of controversy [1]. Recently, even endobronchial valves have been inserted to control a persistent air leak [3].

In this manuscript the authors address a very specific category of parietal pleural tears; those occurring during awake coronary artery bypass grafting (CABG) [4]. In their clinical experience respiratory assistance because of pneumothorax was necessary in 15 out of 43 patients (34.9%) with endotracheal intubation required in 2 patients (4.7%). In an experimental setting they developed a promising . . . [Full Text of this Article]