TAILIEUCHUNG - Advanced therapy in thoracic surgery - part 2

Wain và các đồng nghiệp báo cáo đa trung tâm, ngẫu nhiên, thử nghiệm của bệnh nhân trải qua phẫu thuật cắt phổi, so sánh đóng cửa thông thường với việc đóng cửa thông thường cộng với điều trị của tất cả các trang web phẫu thuật có nguy cơ cho không khí bị rò rỉ | Tissue Adhesives in Thoracic and Cardiovascular Surgery 55 there was no significant difference in the length of the hospital A major criticism of this study is the chest tube management which may have contributed to the incidence of empyema and the extended hospital stay. Wain and colleagues reported a multicenter randomized controlled trial of patients undergoing pulmonary resection comparing conventional closure with conventional closure plus treatment of all surgical sites at risk for air leak with Each surgeon was trained in the proper application of FocalSeal and each individual surgeon or institution determined protocol for chest tube management. Of the 117 patients in the FocalSeal group and the 55 patients in the control group there was no statistically significant difference in the extent of prerandomization air leak. The FocalSeal group had no air leak detectable prior to chest closure in 92 of patients compared with 29 in the control group p .001 . In the time from operation to hospital discharge 39 of the patients in the FocalSeal group had no air leak versus 11 in the control group p .001 Figure 3-8 . The mean time from skin closure to the last detectable air leak was less in the FocalSeal group than in controls h vs h respectively p .006 . However as in the previous studies there was not a statistical difference between the groups in time to chest tube removal or length of hospital stay although the trend favored the FocalSeal group Figure 3-9 . FocalSeal has also been used to seal air leaks that develop during cardiac reoperations. Fifteen patients that had air leaks recognized intraoperatively had the pulmonary injuries treated with FocalSeal. All leaks were controlled intraoperatively and 73 of patients had air leaks recognized postoperatively. Three of four patients with a recurrent air leak had the air leak resolved in 3 days but seal was never accomplished in one patient who was .

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