Reinforcement bronchial stump increases early mechanical integrity: an ex-vivo experimental study.
OBJECTIVE
The purpose of this study was to investigate the effects of different bronchial suture techniques, with and without tissue reinforcement, on the resistance to pressure of the bronchial stump.


METHODS
Fifty-four tracheo-bronchial trees obtained from the local slaughterhouse were prepared for manual closure. After right pneumonectomy, specimens were divided into three groups (n = 18). Interrupted suture pattern (group 1), continuous horizontal mattress + over-over continuous pattern (group 2) and continuous over-over + coverage with a diaphragmatic part with interrupted U sutures pattern (group 3) were used for bronchial closure. Multifilament absorbable 4-0 sutures were used in all specimens. Air leakage pressures were measured with a sphygmomanometer.


RESULTS
Groups 1 and 2 had nearly equal mean air leakage pressures (98 +/- 37 and 95 +/- 51 mmHg, respectively, p = 0.985). Group 3 showed significantly higher mean leakage pressure (153 +/- 66 mmHg, p = 0.002) compared to the other groups.


CONCLUSIONS
Reinforcement of the bronchial stump with viable tissue contributes to the bronchial stump integrity by increasing the air leakage resistance.
Department of Thoracic Surgery, Gaziosmanpasa University School of Medicine, Tokat, Turkey. yeginsu@hotmail.com
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Yeginsu
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Ergin
D000388:Air; D000818:Animals; D001980:Bronchi / Q000601:surgery*; D001983:Bronchial Fistula / Q000209:etiology / Q000517:prevention & control*; D003964:Diaphragm / Q000601:surgery; D023421:Models, Animal; D011013:Pneumonectomy / Q000009:adverse effects; D011312:Pressure; D012756:Sheep; D013536:Suture Techniques