title: Reduction of air leaks in a canine model of pulmonary resection with a new staple-line buttress.
abstract: OBJECTIVE
  Recently, linear staplers have been used frequently in thoracic surgery; however, air leakage from the staple line is still unresolved. Various buttress materials have been developed to prevent air leakage, but performance is still not satisfactory. We are therefore developing a new material, consisting of calcium alginate nonwoven fabric covered with sodium alginate sponge.
  
  
  METHODS
  Thirty-three beagle dogs were divided into 7 groups, and each underwent thoracotomy. Right middle lobe incision was performed with a linear stapler and 1 of the following buttress methods: group A, no buttress; group B, polyglycolic acid nonwoven fabric; group C, fibrin glue alone; group D, polyglycolic acid nonwoven fabric with fibrin glue; group E, polyglycomer sheet; group F, new alginate material; and group G, polyglycolic acid nonwoven fabric plus new alginate material. Burst pressures were measured under mechanical ventilation management.
  
  
  RESULTS
  Burst pressures were 12.0 ± 6.8 cm H(2)O in group A, 31.3 ± 6.6 cm H(2)O in group B, 13.9 ± 3.8 cm H(2)O in group C, 26.9 ± 2.8 cm H(2)O in group D, 24.8 ± 1.8 cm H(2)O in group E, 48.5 ± 4.9 cm H(2)O in group F, and 54.2 ± 12.4 cm H(2)O in group G. F and G group pressures reached the target of 40 to 50 cm H(2)O and were significantly higher than those of the 5 conventional groups (P < .0005)
  
  
  CONCLUSIONS
  This alginate buttress should be effective for preventing air leakage during operations because it has both sealant and bolster effects working in conjunction.
authors.affiliation: Medical Life System, Faculty of Life and Medical Science, Doshisha University, Kyotanabe, Kyoto, Japan. aayumihashimoto@gmail.com
authors.forename: Ayumi
authors.initials: A
authors.lastname: Hashimoto
authors.forename: Masaki
authors.initials: M
authors.lastname: Kuwabara
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Hirasaki
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsujimoto
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Torii
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Nakamura
authors.forename: Akeo
authors.initials: A
authors.lastname: Hagiwara
mesh_terms: D000388:Air; D000464:Alginates; D000818:Animals; D004285:Dogs; D005260:Female; D015718:Fibrin Tissue Adhesive; D020723:Glucuronic Acid; D006603:Hexuronic Acids; D011013:Pneumonectomy / Q000295:instrumentation*; D011030:Pneumothorax / Q000517:prevention & control; D011100:Polyglycolic Acid; D011183:Postoperative Complications / Q000517:prevention & control; D013528:Surgical Staplers; D013537:Sutures
chemical_list: D000464:Alginates; D015718:Fibrin Tissue Adhesive; D006603:Hexuronic Acids; D011100:Polyglycolic Acid; D020723:Glucuronic Acid