The intracorporeal use of 2-octyl cyanoacrylate resin to control air leaks after lung resection

Objective: To describe the outcome of patients who had 2-octyl cyanoacrylate used as an adjunct to control air leaks after lung resection by application directly onto the visceral pleura. Methods: A retrospective review of these patients from 2007 to 2009 from a single surgeon's practice. Results: Seven challenging patients had 2-octyl cyanoacrylate used to control difficult air leaks after lung resection. The indications included lack of standard sealants in patients with emphysematous lung that would not hold suture and vast air leaks after decortications or extensive nonanatomic resections in patients that would not tolerate the loss of tidal volume. All air leaks sealed immediately and none of the patients left the operating theater with an air leak, including three patients who underwent difficult decortications for empyema. All patients recovered uneventfully, except one patient who died from acute respiratory distress syndrome. His postmortem examination revealed that the resin remained intact on the lung without signs of degradation after being in an intracorporeal environment for weeks. There were no complications nor toxicity directly related to the 2-octyl cyanoacrylate resin. Conclusions: 2-Octyl cyanoacrylate is extremely effective in immediately controlling air leaks, with the results being seen instantly. It dries quickly, does not wash off the lung, and remains intact on the visceral pleura for several weeks. 2-Octyl cyanoacrylate deserves additional testing as an adjunct to control air leaks after lung resection. (C) 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.