Interlobar fixation using TachoSil®: a novel technique

Alfonso Fiorelli, Roberto Scaramuzzi, Saveria Costanzo, Antonio Volpicelli, Mario Santini


Background: We evaluated the use of TachoSil® for anchoring middle lobe to lower lobe after upper right lobectomy.
Methods: The fixation of middle lobe to lower lobe was required in 39/213 consecutive upper lobectomies. In 19/39 (49%) cases, it was performed with suturing and/or stapler (standard group) and in 20 cases (TachoSil group) with Tachosil® alone.
Results: The operative time, complications, length of chest drain and hospital stay were similar between two groups. However, standard compared to TachoSil® group presented a higher incidence of atelectasis (5% vs. 0%, P=0.4) and air leaks (5% vs. 0%, P=0.4) but it did not reach significant difference. Our technique was safe, easy, and quick.
Conclusions: Upon contact with pleura, the clotting factors of TachoSil® dissolved and formed a fibrin network which glued the collagen sponge to the pleura surface. It allowed to fix the middle lobe to lower lobe without restricting lung re-expansion and/or injuring the parenchyma.