Intrapleural administration of a large amount of diluted fibrin glue for intractable pulmonary fistula after thoracic surgery

A clinical study based on 25 cases, including 2 unsuccessful ones

Abstract

Objective: If an air leakage from a resected lung surface persists, patients sometimes have to undergo a reoperation. We evaluated the effectiveness of a methods we developed for intrapleural administration of diluted fibrin glue. Methods: Fibrin glue was diluted 4-fold with saline and/or contrast media. Pleurodesis with a large amount of the diluted fibrin glue was performed in 25 patients with intractable pulmonary fistula after thoracic surgery. Results: The air leaks were stopped by the administration of the glue in all except 2 patients, and recurrence was not seen. Pyrexia (7.4%) and chest discomfort (11.1%) were observed as side effects, but there was no occurrence of severe chest pain or thoracic empyema. Conclusions: These results suggested that intrapleural administration of a large amount of diluted fibrin glue for intractable pulmonary fistula after thoracic surgery is an effective treatment for post-surgical intractable pulmonary fistula.