The utility of the Stapler with PGA sheet for pulmonary wedge resection: a propensity score-matched analysis

Background: Air leakage is a common complication after pulmonary wedge resection. The aim of this study was to evaluate the effect of staple line reinforcement in reducing air leakage after pulmonary wedge resection. Methods: A retrospective analysis was performed on patients who underwent pulmonary wedge resection. The patients were classified into 2 groups; the Stapler with polyglycolic acid sheet was used for the reinforced and the Stapler without polyglycolic acid sheet was used for the non-reinforced group. The patients were matched one-to-one based on a propensity score that comprised several patient characteristics. A propensity score-matched analysis was performed to compare patient outcomes. Results: A total of 291 patients who met the inclusion criteria were investigated. There were 165 in the reinforced group and 126 patients in the non-reinforced group. Propensity score analysis generated 104 matched pairs of patients in both the reinforced and the non-reinforced groups. The rate of non-placement of chest tube was significantly higher in the reinforced group than in the non-reinforced group (61.5% vs. 36.5%; P<0.001). The rate of postoperative air leakage was higher in the non-reinforced group than in the reinforced group (13.5% vs. 1.9%, P<0.001). On logistic regression analysis, not using the reinforcement device was one of the independent factors related to pulmonary air leakage after pulmonary wedge resection (OR: 8.58, P<0.001). Conclusions: The use of the Stapler with polyglycolic acid sheet during pulmonary wedge resection increased the rate of intraoperative chest tube removal and reduced the rate of postoperative air leakage.