DO PERICARDIAL STRIPS (PERI-STRIP(R)) IMP ROVE OUTCOME AFTER PULMONARY SURGERY IN EMPHYSEMATOUS PATIENTS

The aim of this study was to evaluate the contribution of bovine peric ardial strips (Peri-Strip(R)) to achieve aerostasis within emphysemato us lungs. A preliminary evaluation included 15 patients (13 men and 2 women, mean age 57 years) with severe emphysema (mean FEV-1 : 28.6 +/- 10.2 % of predicted, mean RV : 18.4 +/- 41.3 % of predicted). Two pat ients were on ventilator owing to acute respiratory failure. Indicatio n for surgery was elective surgery for emphysema in 9 patients, emerge ncy surgery for emphysema in 2, and resection for bronchogenic cancer in 4 patients. The various procedures included single aerostasis in I, unilateral bullectomy in 6, bilateral volume reduction in 4, thoracos copic wedge resection for peripheral cancer in 1 and lobectomy for can cer in 3 (2 of which underwent simultaneous bullectomy) Peri-Strip(R) were used to buttress the staple lines at the base of bullae, on paren chymatous transsection lines, and on the borders of fissures. One pati ent who underwent emergency thoracotomy for single aerostasis died 8 d ays post-operatively dire to multiple organ failure. Another patient d eveloped pneumonia which resolved under treatment. Mean duration of ai r leaks was 5.6 days (0-21, median 2). Mean duration of drainage was 9 .2 days (4-22, median 8). Two patients required tube thoracotomy for r esidual effusions. Mean hospital stay was 17 days (6-53; median 16). W e conclude that use of Peri-Strip(R) offered a real benefit to 12 pati ents; no evidence of benefit was noted in 3 patients.