Pilot study on the feasibility and preliminary outcomes of fibrin glue patch versus electrocautery after thoracoscopic lung

Background
Thoracoscopic lung biopsy plays a pivotal role in detecting diffuse parenchymal lung diseases. However, postoperative complications, particularly prolonged air leaks, remain a significant challenge.


Objective
This pilot randomized study was designed to assess the feasibility, safety, and preliminary efficacy of applying a fibrin glue patch to the biopsy site compared with electrocautery in reducing postoperative complications in patients after thoracoscopic lung biopsy.


Patients and methods

A pilot prospective randomized controlled trial was conducted at Mansoura University Hospitals involving 22 patients with undiagnosed diffuse parenchymal lung diseases. Patients were indiscriminately allocated to two groups: group 1 (
n
=11): fibrin glue patch application at the biopsy site, and group 2 (
n
=11) underwent electrocautery. The primary outcome was to detect persistent air leak after thoracoscopic lung biopsy.



Results

The fibrin glue group demonstrated significantly better outcomes, including a reduced median duration of hospital stay (6 vs. 8 days,
P
=0.01), reduced chest tube duration (5 vs. 9 days,
P
=0.01), and faster lung re-expansion (1 vs. 4 days;
P
=0.001). Persistent air leak was reported in only one patient in the electrocautery group. Surgical emphysema was detected more frequently in the electrocautery group (3 vs. 1 cases), though this was not statistically significant.



Conclusion
Fibrin glue patch application during thoracoscopy is a safe and feasible method that may enhance postoperative recovery by minimizing air leak, shortening chest tube duration, and reducing hospital stays. As this was a pilot study with a limited sample size, findings should be considered preliminary; larger, multicenter trials are warranted.