Air leak and intraoperative bleeding in thoracic surgery: a Delphi consensus among the members of Italian society of thoracic surgery.

Autor:	Cardillo G; Department of Thoracic Surgery, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy.; Unicamillus - Saint Camillus International University of Health Sciences, Rome, Italy., Nosotti M; University of Milan, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy., Scarci M; Imperial College Healthcare NHS Trust, London, UK., Torre M; Department of Thoracic Surgery, ASST GOM Niguarda, Milan, Italy., Alloisio M; Division of Thoracic Surgery, IRCCS Humanitas Research Hospital, Rozzano, Italy.; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy., Benvenuti MR; Thoracic Surgery, Cardiothoracic Department, ASST, Spedali Civili, Brescia, Italy., Bertani A; Thoracic Surgery and Lung Transplant Division, IRCCS ISMETT - UPMC, Palermo, Italy., Cagini L; Department of Thoracic Surgery, University of Perugia, Perugia, Italy.; Thoracic Surgery Department, Ospedale del Mare, Naples, Italy., Casablanca G; Department of Thoracic Surgery, SC AO Papardo of Messina, Messina, Italy., Cavallesco G; Department of Surgery 1 Thoracic, Hospital Unit University of Ferrara, Ferrara, Italy., Cherchi R; Department of Thoracic Surgery, U.O.C A.R.N.A.S. -Brotzu, Cagliari, Italy., Crucitti P; Department of Thoracic Surgery, Fondazione Policlinico Campus Bio-Medico of Rome, Rome, Italy., Curcio C; UOC Thoracic Surgery, AORN dei Colli. Monaldi Hospital, Naples, Italy., Denegri A; Department of Thoracic Surgery, UOC Azienda Ospedaliera SS Annunziata Cosenza, Cosenza, Italy., Droghetti A; Department of Thoracic Surgery, ASST Mantova, Mantova, Italy., Guggino G; Department of Thoracic Surgery, UOC Azienda Ospedaliera Rilievo Nazionale 'A. Cardarelli', Naples, Italy., Imperatori A; Center for Thoracic Surgery, Department of Medicine and Surgery, University of Insubria, Varese, Italy., Infante MV; Thoracic Surgery Department, University and Hospital Trust-Ospedale Borgo Trento, Verona, Italy., Lucchi M; Division of Thoracic Surgery, University of Pisa, Pisa, Italy., Macrì P; Department of Thoracic Surgery, Humanitas Istituto Clinico Catanese, Misterbianco, Italy., Marulli G; Thoracic Surgery Unit, Department of Emergency and Organ Transplantation, University Hospital of Bari, Bari, Italy., Melloni G; Department of Thoracic Surgery, S.Croce e Carle General Hospital, Cuneo, Italy., Paci M; Department of Thoracic Surgery, Azienda Unità Sanitaria Locale-IRCCS, Reggio Emilia, Italy., Paladini P; Department of Thoracic Surgery, University of Siena, Siena, Italy., Pariscenti GL; Department of Thoracic Surgery, IRCCS San Martino Polyclinic Hospital, Genoa, Italy., Potenza E; Department of Thoracic Surgery, U.O.C. A.O.R.N.A.S. Garibaldi Nesima, Catania, Italy., Rea F; Unit of Thoracic Surgery and Lung Transplantation, Department of Cardio-Thoracic and Vascular Sciences and Public Health, University of Padova, Padova, Italy., Refai M; Department of Thoracic Surgery, AOU Ospedali Riuniti, Ancona, Italy., Rena O; Thoracic Surgery Unit, University Hospital 'Maggiore della Carità', Novara, Italy., Ricciardi S; Unit of Thoracic Surgery, San Camillo Forlanini Hospital, Rome, Italy.; PhD Program, Alma Mater Studiorum, University of Bologna, Bologna, Italy., Rusca M, Sollitto F, Taurchini M; Department of Thoracic Surgery, UOC Policlinico SS Annunziata Asl Taranto, Taranto, Italy., Terzi A; IRCCS Sacro Cuore-Don Calabria, Hospital Negrar di Valpolicella, Valpolicella, Italy., Voltolini L; Thoracic Surgery Unit, University Hospital Careggi, Florence, Italy., Crisci R; Department of Thoracic Surgery, MeSVA Department University of L'Aquila, L'Aquila, Italy.; Division of Thoracic Surgery, 'Mazzini' Hospital, Teramo, Italy.
Jazyk:	angličtina
Zdroj:	Journal of thoracic disease [J Thorac Dis] 2022 Oct; Vol. 14 (10), pp. 3842-3853.
DOI:	10.21037/jtd-22-619
Abstrakt:	Background: Persistent air leak and the management of intraoperative blood loss are common threats in thoracic surgical practice. The availability of new procedures, technology and materials is constantly evolving topical hemostats and surgical sealants must be added to this toolkit. Topical hemostats and surgical sealants differ according to their chemical nature and physical characteristics, to their origin and mechanism of action, regulatory/registration and vigilance paths. A Delphi consensus was set to highlight the different points of view on the use of topical haemostatic products and sealants among the members of Italian Society of thoracic surgery. Methods: The board was formed by a group of five Italian experts; in the first phase after a careful review of the scientific literature and two rounds, the board finally generated 16 consensus statements for testing across a wider audience. During the second phase, the statements were collated into a questionnaire, which was electronically sent to a panel of 46 Italian surgeons, experts in the field. Results: Out of 46 Italian surgeons, 33 (72%) panel members responded to the Delphi questionnaire. All the items reached a positive consensus, with elevated levels of agreement, as demonstrated by the presence of a 100% consensus for nine items. For the remaining 7 statements the minimum level of consent was 88% (29 participants approved the statement and 4 disagreed) and the maximum was 97% (32 participants approved the statement and 1 was in disagreement). Conclusions: The present Delphi analysis shows that air leak and intraoperative bleeding are clinical problems well known among thoracic surgeons. Nevertheless, the aim of the scientific societies and of the group of experts is to execute the education activities in the surgery community. This Delphi survey suggest the need of wider and updated scientific information about technical and registration characteristics of most recent technologic solutions, such as the of topical hemostats and surgical sealants to provide healthcare and administrative staff with the opportunity to work and interact through a common and shared language and eventually to guarantee minimal requirements of assistance. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-22-619/coif). PC serves as an unpaid editorial board member of Journal of Thoracic Disease from November 2020 to October 2022. GM serves as an unpaid editorial board member of Journal of Thoracic Disease from February 2021 to January 2023. LV serves as an unpaid editorial board member of Journal of Thoracic Disease from October 2022 to September 2024. GC participated on an Advisory Board supported by BD in the past 36 months. MN participated on an Advisory Board supported by Bard Limited in the past 36 months. MS received honoraria by J&J, Medtronic and Medela for speakers fee, and participated on an Advisory Board supported by BD, and he was a member of ESTS board of directors in the past 36 months. MT participated on an Advisory Board supported by BD in the past 36 months. GC is an unpaid member of the Oncologic network of Sicilian Region in the past 36 months. AI is an unpaid member of Editorial Board of the “Monaldi Archives for Chest Disease” and unpaid member of Editorial Board of the Video-Assisted Thoracic Surgery in the past 36 months. GLP is an unpaid Councillor of the Italian Thoracic Surgery Society from 2021 to 2023 and an unpaid Scientific Coordinator Pulmonary Nodule Recommendations Group PNR of Italian Thoracic Surgery Society from 2021 to 2023. RC participated on an Advisory Board supported by BD in the past 36 months. The other authors have no conflicts of interest to declare. (2022 Journal of Thoracic Disease. All rights reserved.)
Databáze:	MEDLINE
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