fibrinogen and thrombin to reduce air leak, duration of drainage and hospital stay. We welcome their conclusion on the safety and efficacy of biosynthetic sealants to minimise air leaks, a finding which contrasts the conclusions of a recent Cochrane review based on the results of trials that were selected for inclusion [2]. Unfortunately, we cannot agree with their statement that theirs was the...

Endobronchial valves are increasingly used as a treatment modality as a less invasive alternative to lung volume reduction surgery in patients with severe emphysema. Endobronchial valves have also been used to treat patients with persistent pulmonary air leaks and those with bronchopleural fistulae. We report a case of a 61-year-old male with severe bullous emphysema. Following video-assisted t...

A 68-year-old white man with lung carcinoma underwent removal of the lower lobe of the left lung. Four months later, the patient developed a hemothorax requiring exploratory thoracotomy, evacuation of hemothorax, and decortication. Postoperatively a persistent airspace with prolonged air leak developed. Bronchoscopic application of fibrin glue failed to seal the leak. Percutaneous transthoracic...

OBJECTIVE To evaluate two different approaches used to perform fused fissures in lobectomies in terms of persistent air leak (PAL) and their impact on length of hospital stay. METHODS One hundred and nineteen patients underwent lobectomy or bilobectomy in our unit. We focused on patients with fused fissures (63 patients), all of whom were selected intraoperatively based on predefined criteria...

BACKGROUND The goal of this prospective study was to determine risk factors for prolonged air leak (PAL) for patients who underwent video-assisted thoracoscopic surgery (VATS) for spontaneous pneumothorax. METHODS Between January 2002 and June 2012, a total of 2,292 patients were eligible for enrollment in the study: 1,800 patients had primary spontaneous pneumothorax and 492 patients had sec...

BACKGROUND In chemical pleurodesis for managing pulmonary air leak, tetracycline derivatives are commonly used, and their effectiveness has been established in many studies. Recently, a Viscum album extract was used in chemical pleurodesis. We compared the effects of V. album with those of a tetracycline derivative (doxycycline) to demonstrate the therapeutic effectiveness of the V. album extra...