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Eur J Cardiothorac Surg 2007;32:552-553. doi:10.1016/j.ejcts.2007.06.005
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved

Letters to the Editor

Surgical sealants for air leaks after pulmonary surgery

Eric Lim*, Peter Goldstraw

Department of Thoracic Surgery, Royal Brompton Hospital, London, UK

Received 22 February 2007; accepted 4 June 2007.

* Corresponding author. Address: Department of Thoracic Surgery, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK. Tel.: +44 207 352 8121. (Email: e.lim{at}rbht.nhs.uk).

Key Words: Surgical sealants • Hospital stay

We read with interest the study by Anegg et al. [1] on the effectiveness of TachoSil, a collagen patch coated with fibrinogen and thrombin to reduce air leak, duration of drainage and hospital stay.

We welcome their conclusion on the safety and efficacy of biosynthetic sealants to minimise air leaks, a finding which contrasts the conclusions of a recent Cochrane review based on the results of trials that were selected for inclusion [2].

Unfortunately, we cannot agree with their statement that theirs was the only trial of sealants to demonstrate benefits in both time to drain removal and hospital discharge. Our study at the Brompton Hospital published in February 2006 demonstrated significant reduction in the duration of air leak (1 vs 4 days; P < 0.001), duration of chest drain (4 vs 5 days; P = 0.012) and hospital stay (6 vs 7 days; P = 0.004) [3].

Nevertheless, we would agree that further investigation is appropriate. However, with the demonstrated efficacy of surgical sealants, the question should not focus on efficacy compared to control, but rather relative efficacy between different forms of sealants.

Footnotes

\#9734; The authors of the original paper were invited to respond but failed to do so in the appropriate manner.

References

  1. Anegg U, Lindenmann J, Matzi V, Smolle J, Maier A, Smolle-Juttner F. Efficiency of fleece-bound sealing (TachoSil((R))) of air leaks in lung surgery: a prospective randomised trial. Eur J Cardiothorac Surg 2007;31:198-202.[Abstract/Free Full Text]
  2. Serra-Mitjans M, Belda-Sanchis J, Rami-Porta R. Surgical sealant for preventing air leaks after pulmonary resections in patients with lung cancer. Cochrane Database Syst Rev (Online) 2005:CD003051.
  3. Tansley P, Al-Mulhim F, Lim E, Ladas G, Goldstraw P. A prospective, randomized, controlled trial of the effectiveness of BioGlue in treating alveolar air leaks. J Thorac Cardiovasc Surg 2006;132:105-112.[Abstract/Free Full Text]




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