Mechanical vascular division in lung resection

Hisao Asamura, Kenji Suzuki, Haruhiko Kondo, Ryosuke Tsuchiya

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background: There is little information available regarding the relative advantage of stapling over ligation for major pulmonary vessels in lung resection. The thin and fragile structure of pulmonary vascular walls for their large luminal size might have made surgeons reluctant to use staplers. This study was intended to demonstrate the feasibility of pulmonary vascular division by staplers. Methods: A total of 842 mechanical vascular divisions were performed for pulmonary artery (PA, n=376), pulmonary vein (PV, n=462), and azygos vein (AV, n=4) in 603 consecutive pulmonary resections from 1997 to 1999 at the National Cancer Center Hospital, Tokyo. In this series, 99.8% of mechanical vascular divisions were performed with endostaplers (840 vessels), and only 0.2% was performed with conventional TA-type staplers (two vessels). The prevalence of problems related to mechanical stapling (stapling failure) and postoperative bleeding was studied retrospectively. Results: There was only one incidence of stapling failure, in which the superior pulmonary vein was divided without the formation of staples (overall stapling failure rate, 0.1%). The bleeding was controlled by ligation of each divided stump during thoracotomy. There was no stapling failure for PAs or AVs. In no case did postoperative bleeding require rethoracotomy at the stapled line of the vessels. Conclusions: Although temporary oozing was sometimes seen along the staple line, vascular division with endostaplers was highly reliable with only a 0.1% incidence of stapling failure for all kinds of vascular structures in the thorax.

Original languageEnglish
Pages (from-to)879-882
Number of pages4
JournalEuropean Journal of Cardio-thoracic Surgery
Volume21
Issue number5
DOIs
Publication statusPublished - 2002
Externally publishedYes

Fingerprint

Blood Vessels
Lung
Pulmonary Veins
Hemorrhage
Ligation
Azygos Vein
Cancer Care Facilities
Tokyo
Incidence
Thoracotomy
Pulmonary Artery
Thorax

Keywords

  • Lung cancer
  • Pulmonary vessels
  • Stapling
  • Surgery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Mechanical vascular division in lung resection. / Asamura, Hisao; Suzuki, Kenji; Kondo, Haruhiko; Tsuchiya, Ryosuke.

In: European Journal of Cardio-thoracic Surgery, Vol. 21, No. 5, 2002, p. 879-882.

Research output: Contribution to journalArticle

Asamura, Hisao ; Suzuki, Kenji ; Kondo, Haruhiko ; Tsuchiya, Ryosuke. / Mechanical vascular division in lung resection. In: European Journal of Cardio-thoracic Surgery. 2002 ; Vol. 21, No. 5. pp. 879-882.
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abstract = "Background: There is little information available regarding the relative advantage of stapling over ligation for major pulmonary vessels in lung resection. The thin and fragile structure of pulmonary vascular walls for their large luminal size might have made surgeons reluctant to use staplers. This study was intended to demonstrate the feasibility of pulmonary vascular division by staplers. Methods: A total of 842 mechanical vascular divisions were performed for pulmonary artery (PA, n=376), pulmonary vein (PV, n=462), and azygos vein (AV, n=4) in 603 consecutive pulmonary resections from 1997 to 1999 at the National Cancer Center Hospital, Tokyo. In this series, 99.8{\%} of mechanical vascular divisions were performed with endostaplers (840 vessels), and only 0.2{\%} was performed with conventional TA-type staplers (two vessels). The prevalence of problems related to mechanical stapling (stapling failure) and postoperative bleeding was studied retrospectively. Results: There was only one incidence of stapling failure, in which the superior pulmonary vein was divided without the formation of staples (overall stapling failure rate, 0.1{\%}). The bleeding was controlled by ligation of each divided stump during thoracotomy. There was no stapling failure for PAs or AVs. In no case did postoperative bleeding require rethoracotomy at the stapled line of the vessels. Conclusions: Although temporary oozing was sometimes seen along the staple line, vascular division with endostaplers was highly reliable with only a 0.1{\%} incidence of stapling failure for all kinds of vascular structures in the thorax.",
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