title: Major Lung Resections Using Manual Suturing Versus Staplers During Fiscal Crisis.
abstract: AbstractObjective: During fiscal crisis there was a period of shortage of staplers in our hospital, which drove us to manual suturing of bronchi and pulmonary vessels during major lung resections. We present our experience during that period in comparison to a subsequent period when staplers became available again.
  
  
  METHODS
  A total of 256 lobectomies and 78 pneumonectomies were performed using manual suturing (group A), between September 2009 and September 2010, and compared regarding surgical outcome to 248 lobectomies and 60 pneumonectomies using staplers (group B), between September 2011 and September 2012.
  
  
  RESULTS
  Although we did not observe statistically significant differences but only a trend towards less operative time, for both lobectomies (p=0.21) and pneumonectomies (p=0.31), we actually noted a 41 and 47 minutes saving of operative time using staplers (group B), in comparison to manual suturing (group A). We also observed a trend towards less morbidity rates in patients of group B, who underwent lobectomy (10.48%), and pneumonectomy (20%), versus patients of group A, who underwent lobectomy (15.62%), and pneumonectomy (30.76%); we did not observe any substantial differences in the other surgical outcome variables, and in patients' demographics comorbidities, and anatomic allocation of surgical procedures performed.
  
  
  CONCLUSIONS
  The use of staplers offers safety with secure bronchial or vascular sealing, and saving of operative time. Their unavailability at an interval during fiscal crisis although it did not affect surgical outcome, revealed their usefulness and value.
authors.affiliation: b General Hospital Sotiria, Athens, 115 27, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Potaris
authors.affiliation: c Department of Thoracic Surgery, Sotiria General Hospital, Athens, GR.
authors.forename: Emmanuil
authors.initials: E
authors.lastname: Kapetanakis
authors.affiliation: f Department of Anesthesiology, Sotiria General Hospital, Athens, GR.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Papamichail
authors.affiliation: g Department of Anesthesiology, Sotiria General Hospital, Athens, GR.
authors.forename: Elena
authors.initials: E
authors.lastname: Midvighi
authors.affiliation: j Department of Thoracic Surgery Sotiria General Hospital, Athens, GR.
authors.forename: Alexis
authors.initials: A
authors.lastname: Verveniotis
authors.affiliation: k Department of Thoracic Surgery Sotiria General Hospital, Athens, GR.
authors.forename: Fotios
authors.initials: F
authors.lastname: Parissis
authors.affiliation: n Department of Thoracic Surgery Sotiria General Hospital, Athens, GR.
authors.forename: Demetrios
authors.initials: D
authors.lastname: Apostolou
authors.affiliation: o Department of Surgical Nursing Sotiria General Hospital, Athens, GR.
authors.forename: Vaios
authors.initials: V
authors.lastname: Tziortziotis
authors.affiliation: r Department of Surgical Nursing, Sotiria General Hospital, Athens, GR.
authors.forename: Spiridoula
authors.initials: S
authors.lastname: Maimani
authors.affiliation: s Department of Surgical Nursing, Sotiria General Hospital, Athens, GR.
authors.forename: Evangelia
authors.initials: E
authors.lastname: Pouliara
authors.affiliation: v Department of Anesthesiology Sotiria General Hospital, Athens, GR.
authors.forename: Gregorios
authors.initials: G
authors.lastname: Vogiatzis
authors.affiliation: w Department of Thoracic Surgery Sotiria General Hospital, Athens, GR.
authors.forename: Stamatis
authors.initials: S
authors.lastname: Kakaris
authors.affiliation: z Department of Thoracic Surgery Sotiria General Hospital, Athens, GR.
authors.forename: Marios
authors.initials: M
authors.lastname: Konstantinou
keywords: Key words: lung, lobectomy, pneumonectomy, staplers