Usefulness of free pericardial fat pads as pledgets for air leaks in pulmonary resection

• Published in: Surgery today (Tokyo, Japan) Japan), 2023, Vol.53 (1), p.31-41
• Main Authors: Kameyama, Kenji, Ueshima, Yasuo, Ikebe, Satoshi, Nakazono, Chiaki, Urata, Youji, Okada, Satoru, Inoue, Masayoshi
• Format: Article
• Language: English
• Subjects: Medicine; Medicine & Public Health; Original Article; Surgery; Surgical Oncology
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-022-02618-0

Purpose Intraoperative control of air leaks is important for preventing prolonged air leaks after surgery. The usefulness of suturing free pericardial fat pads (FPFPs) as pledgets for repairing air leaks was investigated. Methods A total of 111 patients who underwent anatomical lung resection and required suture repair for intraoperative air leaks were retrospectively reviewed. Mattress sutures were performed using polyglycolic acid (PGA) sheets (PGA group; n  = 60) in the early period (April 2014 to March 2018) and FPFPs (FPFP group; n  = 51) in the late period (April 2018 to March 2021) as pledgets. Results More patients had a history of smoking in the FPFP group than in the PGA group. The duration of air leakage was significantly shorter (mean 1.2 vs. 3.5 days, p  = 0.002) and prolonged air leakage (> 5 days) was less frequently observed (23.3% vs. 5.9%, p  = 0.016) in the FPFP group than in the PGA group. The FPFP group had fewer cases requiring pleurodesis and with recurrent air leaks than in the PGA group. In one case in the FPFP group, fat necrosis with fibrosis and fibrous adhesion to the visceral pleura was found on a pathological examination. Conclusion Parenchymal repair using FPFPs as pledgets can reduce prolonged air leaks after surgery.