Using tissue glues for decreasing alveolar air leak in thoracic surgery

Prolonged air leak is one of the most annoying complications after pulmonary surgery. Studies have shown that patients with more intraoperative air leaks are at higher risk of developing prolonged postoperative air leak. Various types of sealants have been used effectively for decreasing intraoperative alveolar air leak. We decided to compare 3 sealants to determine which was best. This was a prospective nonrandomized study that included 120 patients undergoing pulmonary surgical procedures associated with intraoperative air leak. They were divided into 4 equal groups. In the first group, no sealant was used. Glubran 2 sealant was used in the second group, BioGlue in the third, and TachoSil in the fourth. Preoperative and intraoperative data showed no significant differences among groups, except age which was significantly older in the BioGlue group. Air leak duration and tube duration were significantly shorter in the sealant groups, separately and collectively. No significant difference was found among groups regarding total tube drainage. Also, no significant difference was found between the no-sealant and sealant groups collectively regarding the incidence of postoperative complications, but the BioGlue group had a significantly lower incidence of postoperative complications compared to the no-sealant group. Postoperative hospital stay was significantly shorter in the sealant groups, separately and collectively. Our results support the use of sealants for decreasing alveolar air leak. They were easily used in a short time with no significant superiority of one sealant over the others, except for a lower incidence of postoperative complications with BioGlue