title: Trauma pneumonectomy revisited: the role of simultaneously stapled pneumonectomy.
abstract: OBJECTIVE
  The aim of this study was to compare simultaneously stapled pneumonectomy (SSP) with individual ligation (IND) as a method for performing urgent pneumonectomy (Py) for trauma.
  
  
  METHODS
  Twelve patients who required Py were reviewed. SSP was performed in nine cases and IND in three cases. The two groups had statistically similar injury severity scores, presenting systolic blood pressures, and Trauma and Injury Severity Score derived probabilities of survival. An animal model of Py was developed, in which seven animals underwent SSP and seven underwent IND methods. Burst pressures of the pulmonary artery and bronchus were calculated after 14 days.
  
  
  RESULTS
  There were no differences noted in survival rates between SSP (5 (56%)) and IND (1 (33%)), nor in incidence of bronchopleural fistula. The SSP group had a significantly shorter operative time compared with that of IND (88.9 +/- 14.3 minutes vs 213 +/- 57.8 minutes, respectively, p - 0.01). The animal study revealed no difference in burst pressures of the bronchus (SSP = 662.9 +/- 169.9 mm Hg vs. IND = 591.4 +/- 193.2 mm Hg, p = 0.752) or of the pulmonary artery (SSP = 554.3 +/- 195.1 mm Hg vs. IND = 477.7 +/- 247.5 mm Hg, p = 0.529).
  
  
  CONCLUSIONS
  Survival after pulmonary injuries that require Py depends upon the rapidity of hilar control and of the procedures itself. Simultaneously stapled pneumonectomy is an effective and rapid method of dealing with such rare injuries.
authors.affiliation: Division of Trauma and Critical Care Surgery, Henry Ford Hospital, Detroit, MI 48202, USA.
authors.forename: J W
authors.initials: JW
authors.lastname: Wagner
authors.forename: F N
authors.initials: FN
authors.lastname: Obeid
authors.forename: R C
authors.initials: RC
authors.lastname: Karmy-Jones
authors.forename: G D
authors.initials: GD
authors.lastname: Casey
authors.forename: V J
authors.initials: VJ
authors.lastname: Sorensen
authors.forename: H M
authors.initials: HM
authors.lastname: Horst
mesh_terms: D000328:Adult; D000818:Animals; D004285:Dogs; D005260:Female; D006801:Humans; D008026:Ligation; D008168:Lung / Q000601:surgery; D055370:Lung Injury; D008297:Male; D011013:Pneumonectomy / Q000379:methods*; D012189:Retrospective Studies; D017792:Surgical Stapling; D014948:Wounds, Gunshot / Q000601:surgery*