The use of fibrin glue in the treatment of patients with pleural empyema with bronchopleural fistula

• Nikulin A.V.
• Romanikhin A.I.
• Gandybina E.G.
• Petrovskaya A.A.
• Pаtalova A.R.
• Gorbacheva A.V.
• Yasin A.
• Arkhipova D.S.
• Khorobrykh T.V.

Abstract

The article highlights the results of a cohort pro- and retrospective study involving 136 patients on the use of fibrin glue in the treatment of pleural empyema with bronchopleural fistula. A comparison was made between the use of fibrin glue (group 1, 58+7 patients) and bronchoblocation (group 2, 71 patients) to close bronchopleural fistulas in pleural empyema. 7 patients from group 1 were examined separately because they additionally needed to use a bronchoblocker.

Results. In the first group (FC), complete expansion of the lung was observed in 75.86% (44/58), partial expansion with the outcome of empyema into the slit cavity was observed in 24.14% (14/58). In the second group (BB), complete expansion of the lung was observed in 63.38% (45/71), partial expansion with the outcome of empyema into the slit cavity was observed in 16.9%  (12/71), an undeveloped lung was observed in 19.72% (14/71) of cases. Thus, the effectiveness of treatment in group 1 was 100%; in the group where bronchoblocation was used, 80.3%; in the group where a combination of treatment methods (FC+BB) was used, the effectiveness was 85.7%.

Keywords: empyema; bronchopleural fistula; bronchoblocker; fibrin glue

References

1.     Ualikhanov A., Batyrbekov K. Endoscopic closure of the fistula stump of the bronchus after pulmonectomy. Respir Med Case Rep. 2020; 31: 101249. DOI: https://doi.org/10.1016/j.rmcr.2020.101249  

2.     Fiorelli A., Ferrara V., Bove M., Santini M. Tailored airway stent: the new frontiers of the endoscopic treatment of broncho-pleural fistula. J Thorac Dis. 2019; 11 (suppl 9): 1339. DOI:  https://doi.org/10.21037/jtd.2019.04.07

3.     Yablonsky P.K., Mosin I.V., Sanginov A.B., et al. Omentoplasty as a method of prevention and treatment of incompetence of the stump of the right main bronchus and tracheobronchial (tracheotracheal) anastomosis. Vestnik Avitsenny [Avicenna Bulletin]. 2014; 2 (59): 25–9. (in Russian)

4.     National clinical recommendations «Pleural empyema». In: Association of Thoracic Surgeons of Russia [Electronic resource]. URL: https://www.thoracic.ru/wp-content/uploads/NKR-for-treatment-of-empyema-pleura-_PROJECT_.pdf (date of access December 12, 2022). (in Russian)

5.     Abu-Hijleh M., Styrvoky K., Anand V., et al. Intrabronchial valves for air leaks after lobectomy, segmentectomy, and lung volume reduction surgery. Lung. 2019; 197: 627–33. DOI: https://doi.org/10.1007/s00408-019-00268-7

6.     Klouda T., Gunnlaugsson S., Shashi K., et al. Nonsurgical management of dynamic pneumatocele via endobronchial administration of fibrin sealant. Pediatr Pulmonol. 2021; 56 (10): 3425–8. DOI: https://doi.org/10.1002/ppul.25448

7.     Tchkonia D., Vacharadze K., Mskhaladze T. The efficacy of endobronchial valve therapy in complex treatment of broncho-pleural fistulas. Georgian Med News. 2020; 306: 73–6.

8.     Drobyazgin E.A., Chikinev Yu.V., Shcherbina K.N., et al. Valvular bronchoblocking in the treatment of bronchopleural fistulas. Acta Biomedica Scientifica. 2017; 2 [6 (118)]: 110–3. (in  Russian)

9.     Drobyazgin E.A., Chikinev Yu.V., Sudovykh I.E. Endoscopic valve bronchial blockage in the treatment of bronchopleural fistulas and air leaks. Khirurgiya. Zhurnal imeni N.I. Pirogova [Surgery. The Journal named after N.I. Pirogov]. 2020; (5): 49–57. (in Russian)

10. Waclawiczek H.W., Chmelizek F. Endoscopic treatment of bronchus stump fistulae following pneumonectomy with fibrin sealant in domestic pigs. Thorac Cardiovasc Surg. 1985; 33 (6): 344–6. DOI: https://doi.org/10.1055/s-2007-1014164

11. Turk R., Weidringer J.W., Harte W., Blumel G. Closure of lung leaks by fibrin gluing. Experimental investigations and clinical experience. Thorac Cardiovasc Surg. 1983; 31 (3): 185–6. DOI: https://doi.org/10.1055/s-2007-1021976

12. Meisner H., Struck E., Schmidt-Habelmann P., Sebening F. Fibrin seal application. Clinical experience. Thorac Cardiovasc Surg. 1982; 30 (4): 232–3. DOI: https://doi.org/10.1055/s-2007-1022394

13. Oishi H., Hoshikawa Y., Sado T., et al. A case of successful therapy by intrapleural injection of fibrin glue for chylothorax after lung transplantation for lymphangioleiomyomatosis. Ann Thorac Cardiovasc Surg. 2017; 23 (1): 40–4. DOI: https://doi.org/10.5761/atcs.cr.15-00319

14. Belcher E., Dusmet M., Jordan S., et al. A prospective, randomized trial comparing BioGlue and Vivostat for the control of alveolar air leak. J Thorac Cardiovasc Surg. 2010; 140 (1): 32–8. DOI: https://doi.org/10.1016/j.jtcvs.2009.11.064

15. Sakai T., Matsutani N., Kanai E., et al. Efficacy of a sheet combined with fibrin glue in repair of pleural defect at the early phase after lung surgery in a canine model. Gen Thorac Cardiovasc Surg. 2018; 66: 103–7. DOI: https://doi.org/10.1007/s11748-017-0857-y

16. Ishikawa K., Kato T., Aragaki M., et al. Endobronchial closure of a bronchopleural fistula using a fibrin glue-coated collagen patch and fibrin glue. Ann Thorac Cardiovasc Surg. 2013; 19 (6): 423–7. DOI: https://doi.org/10.5761/atcs.oa.13-00040

17. Thetter O. Fibrin adhesive and its application in thoracic surgery. Thorac Cardiovasc Surg. 1981; 29 (5): 290–2. DOI:  https://doi.org/10.1055/s-2007-1023498

18. Kawamoto N., Okita R., Hayashi M. et al. Suspected fibrin glue-induced acute eosinophilic pneumonia after pulmonary resection: A case report // Thorac Cancer. 2021. P. 1-4. DOI:  10.1111/1759-7714.14040

19. Marwah V., Choudhary R., Kumar T.A., et al. Interventional closure of an unusual broncho-pleural fistula with superglue. Adv Respir Med. 2021; 89 (6): 621–3. DOI: https://doi.org/10.5603/ARM.a2021.0106

20. Kawai N., Kawaguchi T., Suzuki S., et al. Low-voltage coagulation, polyglycolic acid sheets, and fibrin glue to control air leaks in lung surgery. Gen Thorac Cardiovasc Surg. 2017; 65: 705–9. DOI: https://doi.org/10.1007/s11748-017-0829-2

21. Porrello C., Iadicola D., Grutta E.M., Gullo R., Tomasello  G. Routinary use of fibrin sealants to prevent prolonged air leak in thoracic surgery: our experience. G Chir. 2019; 40 (3): 170–3.

22. Kawamoto N., Okita R., Okada M., et al. Fibrin glue-induced eosinophilic pleural effusion after pulmonary resection: a case report. Int J Surg Case Rep. 2021; 85; 106239. DOI: https://doi.org/10.1016/j.ijscr.2021.106239

23. Belboul A., Dernevik L., Aljassim O., et al. The effect of autologous fibrin sealant (Vivostat®) on morbidity after pulmonary lobectomy: a prospective randomised, blinded study. Eur J Cardiothorac Surg. 2004; 26 (6): 1187–91. DOI: https://doi.org/10.1016/j.ejcts.2004.08.009

24. Edwards S.J., Crawford F., van Velthoven M.H., et al. The use of fibrin sealant during non-emergency surgery: a systematic review of the evidence of benefits and harms. Health Technol Assess. 2016; 20 (94): 1–224. DOI: https://doi.org/10.3310/hta20940

25. Battistoni P., Caterino U., Batzella S., et al. The use of polyvinyl alcohol sponge and cyanoacrylate glue in the treatment of large and chronic bronchopleural fistulae following lung cancer resection. Respiration. 2017; 94 (1): 58–61. DOI: https://doi.org/10.1159/000477350

26. Akaogi E., Mitsui K., Sohara Y., et al. Treatment of postoperative chylothorax with intrapleural fibrin glue. Ann Thorac Surg. 1989; 48 (1): 116–8. DOI: https://doi.org/10.1016/0003-4975(89)90193-8

27. Davoli F., Sellitri F., Brandolini J., et al. Use of coagulant spray glue (Glubran 2®) for aerostatic purposes in pulmonary parenchyma resections in pigs: a preliminary study. Eur Surg Res. 2009; 43 (4): 360–4. DOI: https://doi.org/10.1159/000248334

28. Jessen C., Sharma P. Use of fibrin glue in thoracic surgery. Ann Thorac Surg. 1985; 39 (6): 521–4. DOI: https://doi.org/10.1016/s0003-4975(10)61991-1

29. Allama A.M., Elaziz M.E.A. Using tissue glues for decreasing alveolar air leak in thoracic surgery. Asian Cardiovasc Thorac Ann. 2019; 27 (5): 369–73. DOI: https://doi.org/10.1177/0218492319841734

30. Imai K., Matsuzaki I., Minamiya Y., et al. Postoperative bronchial stump fistula after lobectomy: response to occlusion with polyglycolic acid mesh and fibrin glue via bronchoscopy. Gen Thorac Cardiovasc Surg. 2011; 59: 771–4. DOI: https://doi.org/10.1007/s11748-010-0767-8

31. Chernousov A.F., Khorobrykh T.V., Ishchenko O.V., Vasnev O.S. The use of fibrin glue as a reparation stimulator in the treatment of patients with unformed intestinal fistulas. Vestnik khirurgicheskoy gastroenterologii [Bulletin of Surgical Gastroenterology]. 2009; (3): 21–8. (in Russian)

32. Pavlov V.N., Izmaylov A.A., Zaitov I.M., Safiullin R.I. The use of fibrin glue for sealing pyeloureteroanastomoses in an experiment. Vestnik Bashkirskogo universiteta [Bulletin of Bashkir University]. 2006; 11 (4): 42–3. (in Russian)

33. Gallyamov E.A., Romanikhin A.I., Nikulin A.V., et al. Surgical aspects of the treatment of chylothorax (clinical observations and literature review). Khirurgicheskaya praktika [Surgical Practice]. 2022; (4): 61–9. (in Russian)

34. Kazarezov O.V., Korotkikh N.N. The use of the lift technique in the treatment of rectal fistulas. Koloproktologiya [Coloproctology]. 2020; 19 (1): 17. (in Russian)

35. Frolov S.A., Kuz’minov A.M., Vyshegorodtsev D.V. et al. Possibilities of using fibrin glue in the treatment of rectal fistulas. Rossiyskiy zhurnal gastroenterologii, gepatologii, koloproktologii [Russian Journal of Gastroenterology, Hepatology, Coloproctology]. 2019; 29 (1): 31–5. (in Russian)

36. Ektov V.N., Popov R.V., Vollis E.A. Possibilities for improving the results of surgical treatment of rectal fistulas using fibrin glue. Koloproktologiya [Coloproctology]. 2013; (2): 44–9. (in Russian)

37. Nabieva E.R., Yakupova E.R. Fibrin glue as a promising method of treatment for prosthetic hernioplasty. Ustoychivie razvitie nauki i obrazovaniya [Sustainable Development of Science and Education]. 2019; (3): 279–84. (in Russian)

38. Gataullin I.G., Basiashvili G.T. Efficacy and immediate results of radical prostatectomy using fibrin glue in the surgical treatment of prostate cancer. Research’n Practical Medicine Journal. 2018; 5 (2): 157. (in Russian)

39. Ektov V.N., Popov R.V., Vollis E.A. Technical features of surgical treatment of rectal fistulas using fibrin glue. Koloproktologiya [Coloproctology]. 2014; (S3): 45–45a. (in Russian)

40. Pushkar’ D.Yu., Zhivov A.V., Ismailov M.-R.M., Bagaudinov M.R. Results of the use of fibrin glue in the surgical treatment of urethral strictures. Eksperimental’naya i klinicheskaya urologiya [Experimental and Clinical Urology]. 2013; (1): 36–9. (in Russian)

41. Ektov V.N., Popov R.V., Korotkikh N.N., Vollis E.A. The first experience of using fibrin glue in the surgical treatment of rectal fistulas. Vestnik experimental’noy i klinicheskoy khirurgii [Bulletin of Experimental and Clinical Surgery]. 2010; (3): 271–2. (in Russian)

42. Voevodina A.A. Surgical treatment of reflux esophagitis complicated by gastrocardial syndrome: Diss. Moscow, 2022: 185 p. (in Russian)

43. Patent No. 2802125 Russian Federation, IPC A61B 17/94 (2006.01), A61B 1/267 (2006.01), A61L 24/00 (2006.01), A61L 33/00 (2006.01), A61K 33/18 (2006.01), A61K 33/20 (2006.01), A61K 35/16 (2015.01), A61P 11/00 (2006.01). Method of surgical treatment of pleural empyema with bronchopleural fistula: No. 2022127913: appl. 27.10.2022: publ. 22.08.2023. Nikulin A.V., Khorobrikh T.V. 8 p.: ill. (in Russian)

44. Matveev V.Yu., Khasanov R.M., Bondarev A.V., Kulagina  L.Yu. Method of temporary bronchial occlusion and its effectiveness in patients with pleural empyema with bronchopleural fistulas. Prakticheskaya meditsina [Practical Medicine]. 2015; 4-1  (89): 123–8. (in Russian)

45. Kutergin A.V., Shvetsov I.V., Borshchev S.V., et al. Complex surgical treatment of nonspecific acute pleural empyema with bronchopleural fistulas. Meditsinskaya nauka i obrazovaniye Urala [Medical Science and Education of the Urals]. 2008; 9 (3): 19–20. (in Russian)

46. Cepeda S., Torreg A., Pajares V., Trujillo-Reyes J.C. Utilización de un nuevo cianoacrilato como sellante bronquial en el tratamiento endoscópico de la fístula broncopleural. Arch Bronconeumol. 2017; 53 (3): 168–9. DOI: https://doi.org/10.1016/j.arbres.2016.07.005

47. Matveev V.Yu., Khasanov R.M., Bondarev A.V. Optimization of the method of temporary bronchial obturation in the complex treatment of patients with pleural empyema with bronchopleural fistulas. Prakticheskaya meditsina [Practical Medicine]. 2015; 4-1 (89): 117–22. (in Russian)

48. El-Sameed Y., Waness A., Al Shamsi I., Mehta A.C. Endobronchial valves in the management of broncho-pleural and alveolo-pleural fistulae. Lung. 2012; 190: 347–51. DOI: https://doi.org/10.1007/s00408-011-9369-1