Re: A prospective randomised study to assess the efficacy of a surgical sealant to treat air leaks in lung surgery

Abstract

I congratulate the authors for a randomised trial demonstrating the effectiveness of Coseal in reducing intra-operative air leak following lung resection [1] .T he second aim of the study was to assess if Coseal reduced the number of patients with air leaks at 24 and 48 h following surgery. The study data showed that following the application of Coseal, the rate of air leaks increased at 24 and 48 h since the number of patients with air leaks increased from 15% (intra-operative air leaks) to 24% at 48 h in the Coseal group compared with 1% increase in the control group. Hence, the statement that the application of the sealant allowed significant reduction in the number of patients with air leaks assessed at 24 and 48 h after surgery is misleading. Moreover, this may also explain why there was no significant difference in the duration of hospital stay between the two groups instead of medical and surgical factors, as suggested by the authors, since randomisation should account for these factors otherwise the groups are different.