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Related Experiment Videos

Mechanical vascular division in lung resection.

Hisao Asamura1, Kenji Suzuki, Haruhiko Kondo

  • 1Division of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan. hasamura@ncc.go.jp

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|June 14, 2002
PubMed
Summary

Pulmonary vascular division using endostaplers is a safe and effective method in lung resection surgery. This technique demonstrated a very low stapling failure rate of 0.1% in a large patient cohort.

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Area of Science:

  • Thoracic Surgery
  • Surgical Oncology
  • Vascular Surgery

Background:

  • Limited data exists on stapling versus ligation for major pulmonary vessels during lung resection.
  • Surgeons' reluctance to use staplers for pulmonary vessels stems from their thin, fragile walls and large lumens.
  • This study aimed to assess the feasibility of using staplers for pulmonary vascular division.

Purpose of the Study:

  • To evaluate the safety and efficacy of endostapler use for pulmonary vascular division in lung resections.
  • To determine the incidence of stapling failure and postoperative bleeding associated with this technique.

Main Methods:

  • Retrospective analysis of 842 mechanical vascular divisions (pulmonary artery, pulmonary vein, azygos vein) in 603 lung resections (1997-1999).

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  • Primarily utilized endostaplers (99.8%) for vascular division.
  • Assessed stapling failure and postoperative bleeding rates.

    • Main Results:

    • A single stapling failure occurred (0.1%), involving the superior pulmonary vein, which was managed with ligation.
    • No stapling failures were observed for pulmonary arteries or the azygos vein.
    • No instances of postoperative bleeding necessitated rethoracotomy.

    Conclusions:

    • Endovascular stapling is a highly reliable method for thoracic vascular structures.
    • Temporary oozing along the staple line may occur but is generally manageable.
    • The overall stapling failure rate of 0.1% supports the safety and feasibility of this technique.