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Complications of bronchial stapling in thoracic surgery
Motoki Yano1, Kohei Yokoi, Hiroki Numanami
1Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho,Mizuho-ku, Nagoya, Japan, motoki@med.nagoya-cu.ac.jp.
World Journal of Surgery
|October 17, 2013
Summary
Bronchial stapling in thoracic surgery is generally safe, with a 1.8% complication rate. Rare postoperative complications like bronchopleural fistula can be critical, emphasizing the need for awareness.
Area of Science:
- Thoracic Surgery
- Surgical Technology
- Pulmonary Medicine
Background:
- Bronchial stapling is a common and accepted technique in thoracic surgery.
- Despite its widespread use, complications associated with bronchial stapling can occur.
Purpose of the Study:
- To retrospectively analyze the incidence and causes of complications associated with bronchial stapling in thoracic surgery.
Main Methods:
- A multi-institutional retrospective review of bronchial stapling procedures was conducted.
- Data from 2,030 bronchial stapling instances across 29 institutions were analyzed.
Main Results:
- A total of 36 complications (1.8%) were recorded, with 31 intraoperative (air leakage, stapling failure) and 5 postoperative (bronchopleural fistula, bleeding).
- Stapler-tissue thickness mismatch was a primary cause of intraoperative issues. Bronchopleural fistula occurred at a rate of 0.2% and could lead to critical conditions.
- Complications were more frequent in the main bronchus, and stapler compression types were associated with complication incidence.
Conclusions:
- Bronchial stapling is generally safe in contemporary thoracic surgery.
- Awareness of potential complications, particularly rare but critical postoperative events like bronchopleural fistula, is crucial.
- Understanding the causes of stapling complications can help reduce their occurrence.
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