Clinical evaluation of the effectiveness of a new method of sealing sutures in lung surgery: a case-control study

BACKGROUND: Aerostasis after surgical interventions on the lungs, as well as with lung injuries, remains an unresolved problem of pulmonary surgery. The failure of aerostasis is attributed to the main reason for the lengthening of patients’ stay in the hospital, increased treatment costs, and the frequency of empyema. METHODS: A total of 275 patients with various lung pathologies were included in the study and were divided into two groups. In the main group, 131 patients had a new method of sealing sutures while for comparison group (144 patients) additional measures were taken during intraoperative verification to eliminate the incapability of aero- and (or) hemostasis by traditional methods. In the proposed method, after performing the main stage of the operation, intraparenchymal puncturing with a gel substance was performed to achieve local aero- and hemostasis in the area of damaged or sutured lung tissue. RESULTS: The use of this technique has reduced the need for additional manipulations to eliminate the incapability of aero- and hemostasis. The method does not take much time, while it allows you to increase the proportion of primary (after the main stage of the operation) adequate aero- and hemostasis from 75% to 94.7%. CONCLUSIONS: The new technology of introducing a biological implant into the area of damaged lung parenchyma provides increased tightness of sutures, which is justified by a reduction in the frequency of postoperative significant air leakage from 5.6% to 0.8% and parenchymal bleeding from 4.9% to 0.8%.

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