{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T10:07:00Z","timestamp":1780308420135,"version":"3.54.0"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Lung cancer remains the leading cause of cancer-related mortality worldwide. Although minimally invasive surgery continues to advance, postoperative complications (such as pleural effusion and pulmonary air leaks) remain significant challenges, prolonging the duration of chest tube placement and increasing patient burden. This study aimed to systematically evaluate the safety and clinical efficacy of porcine fibrin sealant (PFS, a biological tissue adhesive), in VATS lobectomy for lung cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a single-center, retrospective observational cohort study including 345 lung cancer patients who underwent VATS lobectomy plus systematic lymph node dissection between 2017 and 2023. The patients were divided into a control group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009142) and a PFS group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009203) receiving intraoperative PFS application. The primary endpoints were total postoperative chest drainage volume and the duration of chest tube placement. Secondary endpoints included the incidence of pulmonary air leaks, severely prolonged drainage (&amp;gt;5 days), and other complications. PSM and OW models were employed to adjust for the baseline.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The unadjusted and PSM cohorts demonstrated the statistical benefits of PFS across multiple aspects. After rigorous adjustment using OW, the difference in total drainage volume was attenuated (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.089). Nevertheless, in the OW cohort, PFS still significantly shortened the duration of chest tube placement (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.036) and effectively decreased the occurrence of PAL (0.0% vs. 5.0%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.019) and severely prolonged drainage (0.0% vs. 22.3%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). There were no significant differences in other complications, and no allergic reactions occurred, indicating its good biosafety.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The results demonstrate that the intraoperative application of PFS during VATS lobectomy is safe and effective. It can significantly prevent postoperative pulmonary air leaks and reduce delayed chest tube removal.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1839723","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T09:36:31Z","timestamp":1780306591000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical efficacy and safety of porcine fibrin sealant in video-assisted thoracoscopic surgery lobectomy for lung cancer"],"prefix":"10.3389","volume":"13","author":[{"given":"Teng","family":"Jia","sequence":"first","affiliation":[{"name":"First Clinical Medical College, Shandong University of Traditional Chinese Medicine","place":["Jinan, Shandong, China"]},{"name":"Department of Thoracic Surgery, Binzhou Medical University Hospital","place":["Binzhou, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-hui","family":"Yue","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Binzhou Medical University Hospital","place":["Binzhou, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu-jing","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Binzhou Medical University Hospital","place":["Binzhou, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tian-yu","family":"She","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Binzhou Medical University Hospital","place":["Binzhou, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-gang","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, The Second Qilu Hospital of Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-jie","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, Binzhou Medical University Hospital","place":["Binzhou, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1016\/j.suc.2021.12.001","article-title":"Lung cancer: epidemiology and screening","volume":"102","author":"Oliver","year":"2022","journal-title":"Surg Clin North Am"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1607","DOI":"10.1016\/S0140-6736(21)02333-3","article-title":"Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802\/WJOG4607L): a multicentre, open-label, phase 3, randomised, controlled, non-inferiority 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resection","volume":"77","author":"Allen","year":"2004","journal-title":"Ann Thorac Surg"},{"key":"B12","doi-asserted-by":"publisher","first-page":"4179","DOI":"10.1097\/JS9.0000000000003925","article-title":"Development and validation of a predictive model for acute postoperative pain after thoracoscopic lobectomy in patients with NSCLC: a multicenter retrospective study","volume":"112","author":"Huang","year":"2026","journal-title":"Int J Surg"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1097\/JS9.0000000000004191","article-title":"Clinical efficacy of surgical sealants after pulmonary resection: an individual patient data meta-analysis of randomized controlled trials","author":"Wong","year":"2026","journal-title":"Int J Surg"},{"key":"B14","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1016\/j.jtcvs.2008.02.079","article-title":"Autologous fibrin sealant reduces the incidence of prolonged air leak and duration of chest tube drainage after lung volume reduction surgery: a prospective randomized blinded study","volume":"136","author":"Moser","year":"2008","journal-title":"J Thorac Cardiovasc Surg"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1839723\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T09:36:31Z","timestamp":1780306591000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1839723\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,1]]},"references-count":14,"alternative-id":["10.3389\/fsurg.2026.1839723"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2026.1839723","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,1]]},"article-number":"1839723"}}