Background: Significant intraoperative and postoperative blood loss are rare but possibly life-threatening complications after lung resection surgery either during open or minimally invasive procedure. Microporous Polysaccharide Hemospheres (ARISTA™AH) have demonstrated time-efficient haemostasis, lower post-operative blood volumes and a lower blood transfusion requirement, without any identified adverse events across other specialities.The primary aim of our study was to evaluate the impact of haemostatic agents on short-term postoperative outcomes in thoracic surgery. Methods: We retrospectively reviewed a prospectively collected database of consecutive early-stage lung cancer patients surgically treated in two European centres(October 2020-December 2022).Exclusion criteria:open surgery,patients with coagulopathy/anticoagulant medication,major intraoperative bleeding,non-anatomical lung resection and age <18 years.The cohort was divided into 5 groups according to the haemostatic agent used.Propensity score matching was used to estimate the effect of ARISTA™AH on various intra- and post-operative parameters(continuous and binary outcome modelling). Results:482 patients(M/F:223/259; VATS 97/RATS 385)with a mean age of 68.9(±10.6)years were analysed.In 253 cases ARISTA™AH was intraoperatively used to control bleeding.This cohort of patients had a significant reduction in total drain volume by 135 mls(standard error 53.9; p=0.012).The use of ARISTA™AH did reduce the average length of hospital stay(-1.47 days)and duration of chest drainage(-0.596 days)albeit not significant.In the ARISTA™AH group,we observed no postoperative bleeding,no blood transfusion required,no 30-day mortality and no requirement for redo-surgery.The use of ARISTA™AH significantly reduced the odds of post-operative complications,need for transfusion and redo surgery. Conclusion: Our data showed that Microporous Polysaccharide Hemospheres are a safe and effective haemostatic device.Its use has a positive effect in short term postoperative outcomes of patients surgically treated for early-stage lung cancer.

A right frontoparietal neoplastic lesion was found in a young-aged patient with analgesic refractory headache. Surgical resection was performed, and the pathologist analysis turned out a cellular ependymoma with signs of anaplasia. In the follow-up, a MRI showed a suspicious lesion, so a [18F]Fluorocholine PET/CT was performed. An increased uptake was described in the right parietal region on the margin of residual cystic lesion. The patient got a complete resection which was confirmed later by MR. In the pathology analysis, a focally congestive cerebral parenchyma with a central histiocytic reaction to foreign body area was described. Foreign body reaction in brain tissue is a very rare immune response that has not been well studied. Haemostatic material has been reported as a possible trigger of this response in other organs and could be detected by [18F]FDG PET/CT. Following the experience of the current case report, [18F]Fluorocholine PET/CT could also show a false positive related to foreign body reaction.