The Pressure Resistance of Mechanical Sutures in the Bronchial Stump

• Published in: Journal of Nihon University Medical Association Vol. 75; no. 5; pp. 219 - 222
• Main Authors: Ishimoto, Shinichirou, Muramatsu, Takashi, Shimamura, Mie, Furuichi, Motohiko, Takeshita, Shinji, Tanaka, Youko, Morooka, Hiroaki, Higure, Ryouta, Shiono, Motomi
• Format: Journal Article
• Language: English; Japanese
• Published: NIHON UNIVERSITY MEDICAL ASSOCIATION 01.10.2016
• Subjects: bronchial stump; mechanical suture; pressure resistancet
• ISSN: 0029-0424; 1884-0779
• DOI: 10.4264/numa.75.5_219

We examined the pressure resistance of mechanical sutures in the bronchial stumps in 20 patients following lobectomy. The Echelon® and EndoGIA® automatic suturing devices were used for 10 cases each. Pressure measurements were conducted in a submerged state. The bronchial stump was closed and the distal side of the bronchus clamped. The pressure tube (an 18 G infusion needle) was inserted into the bronchus to allow the injection of air and measure pressure. The mean pressure did not differ significantly in the Echelon® and EndoGIA® groups (112.5 cmH2O vs. 113.5 cmH2O). Sufficient pressure resistance was observed, considering that airway pressure during expiration is usually 20-30 cmH2O. However, there have been some reports showing that many mechanical suturing devices lead to a higher incidence of bronchial stump fistula compared with manual sutures. In the automatic suturing device, the operator cannot freely adjust the tightness. The choice of the stapler and crushing of the bronchus should be considered before stapling in each patient and in consideration of the characteristics of the bronchus.