Effectiveness of fibrin sealant after pulmonary resection: a propensity score matching analysis.

Abstract

Alveolar air leak is a common and troublesome complication after pulmonary resection because it can lead to longer hospital stay and chest tube drainage time. As fibrin sealants are useful in the management of alveolar air leaks, we evaluated their benefit in patients undergoing pulmonary resection. This retrospective study included patients who underwent pulmonary resection in our hospital between 2016 and 2021. We grouped patients on the basis of whether fibrin sealant was used during surgery and compared outcomes between those with (fibrin sealant group) and without (control group) sealant use after propensity score matching (1 : 1). During the study period, 375 patients underwent pulmonary resection; of these, fibrin sealant was applied at the staple line in 107 patients (fibrin sealant group), whereas sealant was not used in 268 patients (control group). After propensity score matching (1 : 1), there were 95 patients in both groups. There were no differences between the two groups in duration of chest tube drainage (3 days vs. 3 days; p = 0.753) or length of hospital stay (5 days vs. 4 days; p = 0.499). However, the sealant group showed higher cost of hospitalization (USD 4,360 vs. 3,614; p < 0.001). Multivariate analysis for identifying risk factors of persistent air leak revealed that male sex and chronic obstructive pulmonary disease were associated. Our results indicate that application of fibrin sealant was not effective in reducing length of hospital stay, duration of chest drains or air leakage.