A Unique Method for Repairing Intraoperative Pulmonary Air Leakage with Both Polyglycolic Acid Sheets and Fibrin Glue

Abstract Background Methods have been developed for preventing delayed bleeding (DB) after gastric endoscopic submucosal dissection (GESD). However, none of the methods can completely prevent DB. We hypothesized that DB could be prevented by a modified search, coagulation, and clipping (MSCC) method for patients at low risk for DB and by combining the use of polyglycolic acid sheets and fibrin glue with the MSCC method (PMSCC method) for patients at high risk for DB (antibleeding [ABI] strategy). This study assessed the technical feasibility of this novel strategy. Method We investigated 123 lesions in 121 consecutive patients who underwent GESD in Kushiro Rosai Hospital between April 2018 and January 2020. The decision for continuation or cessation of antithrombotic agents was based on the Guidelines for Gastroenterological Endoscopy in Patients Undergoing Antithrombotic Treatment. Results Oral antithrombotic agents were administered to 28 patients (22.8%). The en bloc R0 resection rate was 98.4%. The MSCC method and the PMSCC method for preventing DB were performed in 114 and 9 lesions, respectively. The median time of the MSCC method was 16 min, and the median speed (the resection area divided by the time of method used) was 3.6 cm2/10 min. The median time of the PMSCC method was 59 min, and the median speed was 1.3 cm2/10 min. The only delayed procedural adverse event was DB in 1 (0.8%) of the 123 lesions. Conclusions The ABI strategy is feasible for preventing DB both in patients at low risk and in those at high risk for DB after GESD, whereas the PMSCC method may be necessary for reduction of time.

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Nonsuture dural repair using polyglycolic acid mesh and fibrin glue: clinical application to spinal surgery

Surgical Neurology ◽

10.1016/j.surneu.2005.07.059 ◽

2006 ◽

Vol 65 (2) ◽

pp. 136-142 ◽

Cited By ~ 60

Author(s):

Kazutoshi Hida ◽

Satoshi Yamaguchi ◽

Toshitaka Seki ◽

Shunsuke Yano ◽

Minoru Akino ◽

...

Keyword(s):

Fibrin Glue ◽

Clinical Application ◽

Spinal Surgery ◽

Polyglycolic Acid ◽

Dural Repair ◽

Polyglycolic Acid Mesh

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Efficacy of a Pedicled Pericardial Fat Pad Fixed with Fibrin Glue on Postoperative Alveolar Air Leakage

Surgery Today ◽

10.1007/s595-002-8108-z ◽

2002 ◽

Vol 32 (1) ◽

pp. 26-28 ◽

Cited By ~ 6

Author(s):

Masahiro Yoshimura ◽

Noriaki Tsubota ◽

Hidehito Matsuoka ◽

Toshihiko Sakamoto

Keyword(s):

Fibrin Glue ◽

Air Leakage ◽

Fat Pad ◽

Alveolar Air ◽

Pericardial Fat ◽

Pericardial Fat Pad

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Fibrin adhesive and the vaginal vault synthesis on female rabbits abdominal hysterectomies

Acta Cirurgica Brasileira ◽

10.1590/s0102-86502009000100007 ◽

2009 ◽

Vol 24 (1) ◽

pp. 30-35 ◽

Cited By ~ 1

Author(s):

Ari Gonçalves Lima ◽

Murched Omar Taha ◽

Henri Chaplin Rivoire ◽

Anna Tereza Negrini Fagundes ◽

Djalma José Fagundes

Keyword(s):

Fibrin Glue ◽

Granulation Tissue ◽

Fibrous Tissue ◽

Rabbit Model ◽

Abdominal Hysterectomy ◽

Polyglycolic Acid ◽

Vaginal Vault ◽

Fisher Test ◽

Burst Test ◽

Significant Difference

PURPOSE: To investigate the effectiveness of fibrin glue in comparison with polyglycolic acid suture to promote the closure of rabbit's vaginal vault, after abdominal hysterectomy. METHODS: Twenty female, adults, New Zealand rabbits, were submitted to abdominal hysterectomy and randomly distributed to polyglycolic acid suture (G-PA / n=10) or fibrin glue closure of vaginal vault (G-FG / n=10). Radiograph study allowed identifying vault vaginal suture disrupter or fistulas to urinary bladder or rectum. Videovaginoscopy study allowed identifying the presence of cellulites, abscess formation, tissue granulation or granuloma. Vaginal cuff burst test allowed to identify by the escape of air bubbles and rupture pression record. Histological sections stained with Picrosirius red allowed the measure of fibrous tissue healing. RESULTS: The videovaginoscopy identified a significant difference (Fisher Test p<0.3142) of granulation tissue in the animals of G-PA (40%) in comparison with the G-FG (20%). The gross inspection showed the same relation in the granulation tissue occurrence (Fisher test p< 0.1749) with G-PA (50%) and G-FB (20%). The visceral adhesion to the vaginal vault wound was statistical significant (Fisher test p< 0.1749) with G-PA (50%) and G-FG (20%). The pressure of rupture (mm Hg) of the burst test was similar (p<0.0421) in the animals of G-PA (61.5±19.3) and G-FG (72.5±21.9). The collagen matrix of vault wound healing was similar (p< 0.0231) between the G-PA (31.63±15) and the G-FG (23.2±13.2). CONCLUSION: The vaginal vault closure using the fibrin glue is a safe and reliable procedure after abdominal hysterectomy in female rabbit model.

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Use of fibrin glue sealant with polyglycolic acid sheets to prevent pancreatic fistula formation after laparoscopic-assisted gastrectomy

Surgery Today ◽

10.1007/s00595-012-0253-2 ◽

2012 ◽

Vol 43 (5) ◽

pp. 527-533 ◽

Cited By ~ 16

Author(s):

Yuichiro Hiura ◽

Shuji Takiguchi ◽

Kazuyoshi Yamamoto ◽

Yukinori Kurokawa ◽

Makoto Yamasaki ◽

...

Keyword(s):

Pancreatic Fistula ◽

Fibrin Glue ◽

Polyglycolic Acid ◽

Fistula Formation ◽

Fibrin Glue Sealant ◽

Laparoscopic Assisted

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Comparison of a PGA Sheet with a Commercial ePTFE Sheet as a Staple-Line Reinforcement in Lung Surgery

Key Engineering Materials ◽

10.4028/www.scientific.net/kem.342-343.849 ◽

2007 ◽

Vol 342-343 ◽

pp. 849-852

Author(s):

Keon Hyeon Jo ◽

Seok Whan Moon ◽

Young Du Kim ◽

Young Jo Sa ◽

Si Young Choi ◽

...

Keyword(s):

Statistical Significance ◽

Polyglycolic Acid ◽

Lung Surgery ◽

Resection Margins ◽

Air Leakage ◽

Staple Line Reinforcement ◽

Group I ◽

Significant Difference ◽

Similar Threshold ◽

Group Ii

To prevent prolonged air leakage after lung surgery, we developed a biodegradable polyglycolic acid (PGA) sheet and compared it with an expanded polytetrafluoethylene (ePTFE). Eighteen adult mongrel dogs were used in this experiment. The airway pressures at which air first leaked at the stapled resection margins were measured immediately after surgery in group I (N=5), 2 days after surgery in group II (N=5), and 7 days after surgery in group IIII (N=5), Based on the presence of SLR, there were 3 subgroups in each group: there was no SLR in subgroup a; ePTFE in subgroup b; PGA sheet in subgroup c. The histologic examination was performed 2 months after surgery (N=3). In group I, there was a significant difference in air leakage pressures (mm Hg) between no reinforcement and SLR. We observed the same results in group II and III with statistical significance. However, there was no significant difference between the reinforcement groups. The histologic findings demonstrated more severe adhesions and biodegradation in the dogs in which the PGA sheet was used. Our PGA sheet was considered a useful reinforcement material, because it had a similar threshold for air leakage with the ePTFE with excellent biodegradation.

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