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Randomized Study Comparing Equal Height Staples With Graduated Height Staples in Bronchial Closure.

Jiro Okami1, Toshiteru Tokunaga1, Takashi Kanou1

  • 1Department of General Thoracic Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.

The Annals of Thoracic Surgery
|May 29, 2017
PubMed
Summary

Graduated height staples demonstrated superior staple formation in lung cancer lobectomy compared to equal height staples. Both types showed acceptable clinical performance, with no significant difference in postoperative complications.

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Area of Science:

  • Thoracic Surgery
  • Surgical Oncology
  • Biomaterials Science

Background:

  • Lung cancer operations utilize two staple cartridge types: flat face (equal height staples) and stepped face (graduated height staples).
  • Evaluating the stapling performance of these devices in lobectomy is crucial for optimizing surgical outcomes.

Purpose of the Study:

  • To compare the stapling ability of equal height staples versus graduated height staples for bronchial closure during lung cancer lobectomy.
  • To assess staple formation quality and clinical outcomes associated with each staple type.

Main Methods:

  • A randomized prospective study involving 61 patients undergoing lobectomy.
  • Comparison of staple formation on the resected bronchial stump using roentgenograms, scored on a 0-4 scale.
  • Evaluation of postoperative complications, including bronchopleural fistula.

Main Results:

  • Graduated height staples achieved significantly higher staple formation scores (2.88) than equal height staples (2.17).
  • A significantly greater percentage of graduated height staples formed a complete "B" shape (25.3%) compared to equal height staples (10.0%).
  • No significant differences in postoperative complications were observed between the two groups.

Conclusions:

  • Graduated height staples offer superior staple formation quality for bronchial stumps in lobectomy.
  • Both equal and graduated height staple systems demonstrate acceptable clinical performance and safety in lung cancer surgery.