Reducing Post-Operative Alveolo-Pleural Fistula by Applying PGA-Sheets (Neoveil) after Major Lung Resection: A Historical Case-Control Study

Carolina Sassorossi, Maria Teresa Congedo, Dania Nachira, Diomira Tabacco, Marco Chiappetta, Jessica Evangelista, Adele Di Gioia, Velia Di Resta, Claudio Sorino, Michele Mondoni, Fausto Leoncini, Giuseppe Calabrese, Antonio Giulio Napolitano, Adriana Nocera, Achille Lococo, Stefano Margaritora, Filippo Lococo*

*Corresponding author

Research output: Contribution to journalArticle

Abstract

Alveolo-pleural fistula remains a serious post-operative complication in lung cancer patients after surgery, which is associated with prolonged hospital stay and higher healthcare costs. The aim of this study is to evaluate the efficacy of a polyglycol acid (PGA)-sheet known as Neoveil in preventing post-operative air-leak in cases of detected intra-operative air-leak after lung resection. Between 11/2021 and 7/2022, a total of 329 non-small cell lung cancer (NSCLC) patients were surgically treated in two institutions. Major lung resections were performed in 251 cases. Among them, 44 patients with significant intra-operative air-leak at surgery were treated by reinforcing staple lines with Neoveil (study group). On the other hand, a historical group (selected by propensity score matched analysis) consisting of 44 lung cancer patients with significant intra-operative air leak treated by methods other than the application of sealant patches were considered as the control group. The presence of prolonged air-leak (primary endpoint), pleural drainage duration, hospital stay, and post-operative complication rates were evaluated. The results showed that prolonged air-leak (>5 days after surgery) was not observed in study group, while this event occurred in four patients (9.1%) in the control group. Additionally, a substantial reduction (despite not statistically significant) in the chest tube removal was noted in the study group with respect to the control group (3.5 vs. 4.5, p = 0.189). In addition, a significant decrease in hospital stay (4 vs. 6 days, p = 0.045) and a reduction in post-operative complications (2 vs. 10, p = 0.015) were observed in the study group when compared with the control group. Therefore, in cases associated with intra-operative air-leak after major lung resection, Neoveil was considered a safer and more effective aerostatic tool and represents a viable option during surgical procedures.
Original languageEnglish
Pages (from-to)N/A-N/A
JournalJournal of Clinical Medicine
Volume12
DOIs
Publication statusPublished - 2023

Keywords

  • NSCLC
  • aerostasis
  • air-leak
  • lung cancer
  • lung resection

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