Tissue adhesive in bronchial closure

Monomeric n-butyl-2-cyanoacrylate was used in 25 patientsundergoing pulmonary resections to strengthen the bronchial stump after pneumonectomy (n = 11) and to aid bronchial (n = 13) and tracheal anastomosis (n = 1) after sleeve resections. Neither group had any incidence of bronchopleural fistula. Bronchial anastomosis was accomplished in patients who underwent sleeve resection, reducing the number of sutures required to four apposing sutures, with the tissue adhesive ensuring an airtight closure. There was no incidence of bronchial stenosis. The efficacy of n-butyl-2-cyanoacrylate in preventing fistula formation after bronchial resections makes it an ideal agent in pulmonary surgery. Its use obviated the use of pedicled pleural flap, thus ensuring pleural integrity for extrapleural continuous intercostal nerve blockade for postoperative analgesia.