Fibrin Glue Administration to Support Bronchial Stump Line

Abstract

Bronchopleural fistula is an important cause of mortality and morbidity after pulmonary resection. The use of fibrin glue to reduce the tension and number of sutures in the bronchial stump was assessed in this prospective study of 20 patients between June 2002 and May 2003. They all had a high risk of bronchopleural fistula development because of bronchiectasis, tuberculosis, lung abscess, diabetes mellitus, preoperative neoadjuvant radiotherapy, or residual tumor at the surgical margin. After pulmonary resection, the bronchial stump was closed with separate nonabsorbable sutures supported with fibrin glue. Bronchopleural fistula was observed in only 1 (5%) patient during 6.45 +/- 3.09 months of follow-up. There was no postoperative mortality. Closing the bronchial stump with an appropriate technique and supporting it with fibrin glue were considered effective in preventing bronchopleural fistula development after pulmonary resection in high-risk patients.

Pericardial Flap: An Effective Method of Surgical Repair of Late Post-Pneumonectomy Fistula

“…The application of fibrin glue for reinforcement of the BS after pulmonary resection is well known [41]. In our opinion, the biologic glue improves the seal obtained after suturing the ends on the fistula edges.…”

Repair of postpneumonectomy bronchopleural fistula using pedicled pericardial flap supported by fibrin glue

“…The use of biological glue is an important element of the described PBF closure technique. The use of FG for reinforcement of the bronchial stump after pulmonary resection is well known . In our opinion, the biological glue improves the tightness obtained after knotting the ends at the fistula edges.…”

Modified method for bronchial suture by Ramirez Gama compared to separate stitches suture: experimental study

“…Various tactics describe the importance of a reinforcement on the bronchial suture 2,5 and a range of autologous tissues such as the mediastinal pleura 9 , the pericardium 20 , the fat pad overlying the pericardium 2 , as well as peri-esophageal tissues, the esophagus wall, the omentum and the parietal pleura can be used as the final suture reinforcement. The pedicle of the latissimus dorsi muscle 21 , the flap of intercostal muscle 6,11 , bovine pericardium or biological fibrin glue also have good results 6,11,16,22 .…”

“…The handling of the structures should avoid unnecessary trauma and excessive devascularization of the bronchial stump that may occur after mediastinal lymphadenectomy 2,3 . The bronchopleural fistula (BPF) is a complication of difficult treatment, with high morbidity and mortality 1,[4][5][6][7] .…”