[Biological glue and obstruction of bronchial stumps. Experimental study. Sutureless bronchial closure of lobectomies in dogs].
From April, 1989 to January, 1990, we have been "inducing bronchial fistulae" in dogs by performing 10 lobectomies, 5 middle and 5 caudal, in both the right and the left lung. The bronchial stump was not sutured but closed by a "Tissucol-vicryl mesk" implant, which can be adapted to the size of the stump and is fully absorbed in the long term and replaced by a natural fibrous plug. The results seem to be fairly satisfactory: no dog died; all stumps--followed up a D10, D12... up to the 11th month--were obturated without complications, at least in these animals whose bronchi were normal and not infected. Bronchial fistulae still are a serious complication of lung resections, and while the smaller fistulae (2-3 mm) can be managed with biological glue delivered by simple endoscopy, severe fistulae--especially after pneumonectomy, above all in the right lung--often demand difficult, high-risk surgery. This points out to the interest of this small experimental series. Two conditions are essential to successfully implement this alternative procedure: 1) perfect sterilization of the excision pocket; a window is often required, which in addition has the advantage of facilitating the insertion and observation of the implant; 2) a high concentration of aprotinin (10,000 units) delaying the dissolution of the glue plug, thus allowing it to be integrated by the natural healing process.
Nguyen
H
H
Unité de Chirurgie Thoracique, CHR de Brest, Hôpital Augustin-Morvan.
Nguyen
H V
HV
Briere
J
J
Mondine
P
P
D000269:Adhesives / Q000627:therapeutic use*; D000818:Animals; D007611:Aprotinin / Q000627:therapeutic use; D001983:Bronchial Fistula / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D004285:Dogs; D005402:Fistula / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D010995:Pleural Diseases / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*
D000269:Adhesives; D007611:Aprotinin
Colle biologique et obturation des moignons bronchiques. Etude expériementale. Fermeture bronchique sans suture des lobectomies chez le chien.