He Yang, Zhiqiang Dong, Hongya Wang, Zicheng Liu, Wenbo Sun, Kun Wang, Xinfeng Xu, Wei Wen, Jun Wang, Liang Chen, Quan Zhu
Abstract
Objectives: Pulmonary air leakage is a common complication following lung resection. We have designed a new method combining oxidized regenerated cellulose and fibrin glue to cover the intersegmental plane in clinical lung segmentectomy to prevent postoperative air leakage. In this study, an excised porcine lung segmentectomy model was created to validate its adhesive strength and effect on reducing air leakage. Methods: In the pre-experiment, six different larger lung segments were separated using electrocautery on the fresh isolated porcine lungs (n = 5 in each group). The air leakage degree and operation time of the lung segments were comprehensively evaluated to select the most suitable target segment for establishing the ex vivo porcine lung segmentectomy models. In the experiment, according to the different materials covered on the intersegmental plane, these models were randomly divided into four groups: group A used fibrin glue and oxidized regenerated cellulose (ORC) mesh (n = 20); group B used fibrin glue and polyglycolic acid (PGA) sheet (n = 20); group C used fibrin glue (n = 20); group D was the blank control group (n = 20). The minimum air leakage pressure (MALP) of the selected target segment in each group was measured using a stepwise increase of airway pressure, and histological assessment was performed on the sealed area samples from the four groups. Results: The operation time of the a segment of the right cranial lobe (R1a) was shorter than that of other segments (p < 0.05), and there was no significant difference in the air leakage pressures between the six isolated segments (p = 0.76); thus, R1a was chosen for segmentectomy. In addition, the MALP was significantly higher in group A (41.8 ± 4.5 cmH2O) than in groups C (28.1 ± 2.3 cmH2O) and D (17.3 ± 1.2 cmH2O) (both p < 0.001). The MALP of group B (69.5 ± 5.2 cmH2O) was significantly higher than that of group A (p < 0.001), whereas that of group C was significantly higher than that of group D (p < 0.001). Histological examination confirmed that the combined use of fibrin glue and ORC or PGA patch adhered more firmly to the intersegmental plane than that of fibrin glue alone, although some gaps could be seen between the fibrin glue and the surface of the lung segments in group C. Conclusion: The application of ORC combined with fibrin glue on the intersegmental plane has a good sealing performance in the ex vivo porcine lung segmentectomy model, suggesting that ORC may be an effective alternative material to replace PGA sheet to combine with fibrin glue for preventing air leakage after segmentectomy.
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 22 December 2022.
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#15,219,039
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Outputs from Frontiers in Bioengineering and Biotechnology
#2,279
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#218,952
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Outputs of similar age from Frontiers in Bioengineering and Biotechnology
#85
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Altmetric has tracked 23,393,453 research outputs across all sources so far. This one is in the 32nd percentile – i.e., 32% of other outputs scored the same or lower than it.
So far Altmetric has tracked 7,015 research outputs from this source. They receive a mean Attention Score of 3.6. This one has gotten more attention than average, scoring higher than 61% of its peers.
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We're also able to compare this research output to 544 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 79% of its contemporaries.
