HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Hisao Asamura Kenji Suzuki Haruhiko Kondo Ryosuke Tsuchiya Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Asamura, H. Articles by Tsuchiya, R. Search for Related Content PubMed PubMed Citation Articles by Asamura, H. Articles by Tsuchiya, R. Related Collections Lung - cancer Lung - other

Eur J Cardiothorac Surg 2002;21:879-882
© 2002 Elsevier Science NL

Mechanical vascular division in lung resection

Division of Thoracic Surgery, National Cancer Center Hospital, 1-1 Tsukiji 5-chome, Chuo-ku, Tokyo 104-0045, Japan

Received 11 December 2001; received in revised form 30 January 2002; accepted 11 February 2002.

* Corresponding author. Tel.: +81-3-3542-2511; fax: +81-3-3542-3815
e-mail: hasamura{at}ncc.go.jp

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.

Key Words: Lung cancer • Surgery • Stapling • Pulmonary vessels

This article has been cited by other articles:

				M. F. Szwerc, R. J. Landreneau, R. S. Santos, R. J. Keenan, and G. F. Murray Minithoracotomy combined with mechanically stapled bronchial and vascular ligation for anatomical lung resection Ann. Thorac. Surg., June 1, 2004; 77(6): 1904 - 1910. [Abstract] [Full Text] [PDF]

				N. Shigemura, A. Akashi, T. Nakagiri, M. Ohta, and H. Matsuda A new tissue-sealing technique using the ligasure system for nonanatomical pulmonary resection: preliminary results of sutureless and stapleless thoracoscopic surgery Ann. Thorac. Surg., April 1, 2004; 77(4): 1415 - 1418. [Abstract] [Full Text] [PDF]