title: Granulation tissue formation at the bronchial stump is reduced after stapler closure in comparison to suture closure in dogs.
abstract: The aim of this study was to compare the morphology of the bronchial stump after lobectomy between mechanical stapler closure and manual suture closure. The effect of fibrin glue application on each method of closure was also observed. Right upper lobectomy was performed in beagles (n=31) using staplers (ST group) or sutures (SU group). In a separate experiment, fibrin glue was sprayed onto the stump after each respective method of closure. After one week, the stump region was examined macroscopically, and also by histology. chi(2)-Test and Mann-Whitney test were used for comparative analysis. The incidence of adhesion formation between the surrounding tissues was significantly reduced in the ST group in comparison to the SU group (22 vs. 80%, P=0.04). The thickness of granulation tissue over the stump was significantly reduced in the ST group in comparison to the SU group (0.8+/-0.2 vs. 2.5+/-0.3 mm, P<0.0001). Vessel density in the granulation tissue was also significantly reduced in the ST group in comparison to the SU group (6+/-2 vs. 16+/-2, P=0.003). Fibrin glue application after stapler closure significantly increased the incidence of adhesion formation, granulation tissue thickness, and vessel density in the granulation tissue over the stump.
authors.affiliation: Division of General Thoracic Surgery, Department of Surgery, School of Medicine Keio University, Shinjuku-ku, Tokyo, Japan. yotaroizumi@a2.keio.jp
authors.forename: Yotaro
authors.initials: Y
authors.lastname: Izumi
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kawamura
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Gika
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nomori
mesh_terms: D000818:Animals; D001980:Bronchi / Q000473:pathology / Q000601:surgery*; D016009:Chi-Square Distribution; D004285:Dogs; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage; D006097:Granulation Tissue / Q000473:pathology*; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods*; D017792:Surgical Stapling / Q000009:adverse effects; D013536:Suture Techniques / Q000009:adverse effects; D013908:Thoracotomy; D013997:Time Factors; D000267:Tissue Adhesions; D014014:Tissue Adhesives / Q000008:administration & dosage; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives