THE USE OF TISSUE ADHESIVE IN PULMONARY RESECTIONS

One hundred eighty-seven consecutive patients underwent resection of p rimary bronchogenic carcinoma with intraoperative application of monom eric n-butyl-2-cyanoacrylate glue from July 1987 through December 1992 . The glue reinforced either the stapled bronchial stump (135 patients ), the sutured bronchial anastomosis in sleeve resections (37 patients ) or the staple lines of wedge resections (15 patients). Mortality was 1.6% overall (3 of 187), and 5% among pneumonectomies (2 of 40). Bron chopleural fistulae occurred in 0.5% (1 of 187) of alt pulmonary resec tions and 2.5% of pneumonectomies (1 of 40). There was no fistula in t he lobectomy or sleeve resection groups. Bronchial anastomosis was acc omplished in patients who underwent sleeve resection with four interru pted apposing sutures and airtight closure ensured by the tissue adhes ive. There was no incidence of bronchial stenosis. There were no cyano acrylate adhesive-related complications. A follow-up of the patients u p to 68 months has indicated not only its effectiveness but also its s afety. Monomeric n-butyl-2-cyanoacrylate glue is safe, offers protecti on to bronchial margins and may be valuable in preventing bronchial st enosis after sleeve resections.