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Progressive chest wall bleeding caused by bronchial stump nails after lobectomy
Jichen Qu1, Guangyu Chen2, Boxiong Xie1
1Department of Thoracic Surgery, Shanghai Pulmonary Disease Hospital, Tongji University School of Medicine, Shanghai, China.
The Thoracic and Cardiovascular Surgeon
|July 2, 2014
Summary
Progressive chest wall bleeding after lobectomy can be caused by bronchial stump nails. Careful surgery and awareness of this risk are key to preventing this rare complication.
Area of Science:
- Thoracic Surgery
- Surgical Complications
- Hemostasis
Background:
- Postoperative intrathoracic bleeding is a serious complication in general thoracic surgery.
- Progressive chest wall bleeding from bronchial stump nails after lobectomy is rarely reported.
Purpose of the Study:
- To review the causes, surgical treatment, and prevention of progressive chest wall bleeding caused by bronchial stump nails after lobectomy.
Main Methods:
- Retrospective review of 5,000 lobectomies performed between January 2011 and February 2013.
- Analysis of four cases requiring reexploration for chest wall bleeding due to bronchial stump nails.
Main Results:
- Bleeding originated from the pleura adjacent to the bronchial stump, where staples were used without covers.
- Reoperation involved coagulating and suturing the pleura, removing offending nails, and applying muscle or hemostatic material for separation.
Conclusions:
- Careful surgical technique and understanding the risks associated with bronchial stump nails are crucial for preventing postoperative bleeding.
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