Context: Progel Pleural Air Leak Sealant (CR Bard, Warwick, RI) is a US Food and Drug Administration-approved hydrogel designed for application to surgical staple lines to prevent air leak after lung surgery. This product has demonstrated efficacy in reducing intraoperative air leaks compared with standard air leak closure methods. However, the impact on chest tube duration and length of hospital stay has not been reported.
Objective: To evaluate the effect on rates of postoperative air leak, chest tube duration, and hospital stay in surgical patients with and without use of Progel.
Design: Retrospective study of 176 patients aged 18 to 80 years who underwent video-assisted thoracoscopic wedge resections between 2014 and 2016. Eighty-four (48%) cases using Progel were included, as well as a representative sample of non-Progel cases (n = 92; 52%).
Main Outcome Measure: Presence of postoperative lung air leak.
Results: No difference existed between the Progel and non-Progel groups in the rate of postoperative air leak (20/84, 23.81% Progel; 16/92, 17.39% non-Progel; p = 0.33). The length of time patients had a chest tube was similar (23.5 vs 23 hours, p = 0.721), as was percentage of patients with a less than 2-day hospitalization (77.17% non-Progel vs 82.14% Progel, p = 0.414).
Conclusion: Our results suggest that Progel, used routinely in patients undergoing nonanatomic lung resection, does not have a significant impact on postoperative air leak, chest tube duration, or length of hospital stay. Further studies are warranted to evaluate the utility of Progel in reducing postoperative complications after thoracoscopic wedge resection in those treated for air leak or in the reduction of postoperative air leak in high-risk patients.
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http://dx.doi.org/10.7812/TPP/18-059 | DOI Listing |
In the past 20 years, sulfur hexafluoride (SF) has been considered a highly reliable tracer for assessing modern water (< 65 yrs old) in groundwater. However, modern-air contamination may introduce complications in interpreting data obtained using current sampling methods. A new airtight methodology isolates the sample from modern ambient air; thus, returning more reproducible and reliable results when compared to two traditional (air-sensitive and non-airtight) methods.
View Article and Find Full Text PDFMedicine (Baltimore)
November 2024
Department of Cardiovascular Surgery, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi Province, China.
Background: Transcatheter closure of percutaneous paravalvular leak (PVL) is a technically challenging procedure, especially after surgical mechanical valve replacements (SMVR), as the risk of interference with the prosthetic valve discs and the complex interventional techniques required for mitral PVL closure. Our study was designed to review the results with transcatheter closure of PVL after SMVR.
Methods: From January 2018 through December 2023, a total of 64 patients with PVL after SMVR underwent transcatheter closure with the help of preoperative 3-dimensional printing model and simulator for image evaluation.
Semin Perinatol
December 2024
Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom; Neonatal Intensive Care Unit, University of Patras, Patras, Greece. Electronic address:
Non-invasive ventilation (NIV) is a form of respiratory support provided primarily to preterm born infants in an effort to avoid any endotracheal intubation or as a weaning step following invasive ventilation. In the context of the respiratory distress syndrome of the newborn, NIV could target and partially reverse specific pathophysiological phenomena, by improving alveolar recruitment and establishing adequate functional residual capacity. It can also assist in minimizing lung injury by avoiding excessive pressure delivery, which can be harmful for the developing lung.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
December 2024
Toronto Lung Transplant Program, Toronto General Hospital, Toronto, Canada.
Ex vivo lung perfusion (EVLP) is used to evaluate donor lungs prior to lung transplantation. Development of pulmonary edema during EVLP is generally thought to represent inflammatory breakdown of the air-fluid barrier and these lungs are declined for transplant. We present the case of a donor lung that underwent stapled wedge resection during cold storage for air leak and the subsequent development of profound (∼650 mL) pulmonary edema around the staple line during EVLP.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
September 2024
Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
Background: The real-world safety of robotic resections after neoadjuvant chemoimmunotherapy remains poorly defined in patients with non-small cell lung cancer. Due to reported increased operative challenges after neoadjuvant immunotherapy, we aim to describe our early institutional experience and outcomes after robotic resection in this clinical context.
Methods: We performed a retrospective chart review of patients with non-small cell lung cancer who underwent a robotic lobectomy, comparing patients from June 1, 2022, through October 31, 2023, who were treated with neoadjuvant chemoimmunotherapy consistent with the Checkmate-816 protocol and a control group with upfront resection.
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