Single running suture--the new standard technique for bronchial anastomoses in lung transplantation

The aim of this retrospective study is to assess the results of a single running suture technique for bronchial anastomoses in lung transplantation. In a previous pilot study, equal results compared to the established standard technique --using single stitches on the cartilaginous part--have been described by our group. This report reviews the results obtained over a period of 3 years.

Between January 1999 and December 2001, 154 consecutive lung transplantations (91 bilateral sequential, 35 right single lung and 28 left single lung) were performed in 141 patients using single running sutures for bronchial anastomoses. Thirteen transplantations (25 anastomoses) were performed in lobar or split lung technique. Bronchial healing was assessed at routine bronchoscopes performed in increasing time intervals from 7 days to 1 year postoperatively and depending upon clinical necessity.

Six patients (4.2%) died earlier than 7 days postoperatively and were excluded from further analysis. No bronchial complication was observed in any of them. Three months and 1-year survival rates were 82.9 and 72.7%, respectively. Two hundred and thirty-four anastomoses were subjected to examination. Mean ischemic time was 5.1h (+/-1.5). In 228 anastomoses (97.4%), excellent primary airway healing was observed. In four anastomoses (1.7%), small healing defects less than 5mm without necessity for intervention were detected. Two anastomoses (0.9%) developed a cicatriceal stenosis requiring intraluminal stenting.

The single running suture technique for bronchial anastomoses in lung transplantation provides excellent results with regard to primary and long-term airway healing and its use as a standard suturing technique is, therefore, recommended.