Simultaneous stapling of the lobar bronchus and pulmonary artery: is it actually dangerous?

Interactive Cardiovascular and Thoracic Surgery
Junichi MurakamiKimikazu Hamano

Abstract

We performed a left caudal lobectomy on a 3-month old male swine. During the lobectomy, the lobar bronchus and pulmonary artery were stapled simultaneously using an endostapler. According to a postmortem examination 42 days after the operation, the stumps were surrounded by granulation tissue with prominent accumulation of inflammatory cells. With respect to the bronchus, the stapled tissue remained as it was just after stapling, without degradation of the cartilage, smooth muscle or epithelial layers. In contrast, with respect to the pulmonary artery, the stapled tissue disappeared, which resulted in the formation of a new vascular stump with recruitment of a new adventitial layer and fibrotic tissue. Therefore, despite the simultaneous stapling, the vascular stump was separated from the bronchial stump. Our results suggest that the process of stump healing after stapling of the bronchus is different from that after stapling of the pulmonary artery: bronchial stump healing consists of extraluminal covering of the fibrotic tissues, while pulmonary arterial stump healing consists of intraluminal reformation of the intima and media. On the basis of the results, we believe that a bronchovascular fistula will not develop after simu...Continue Reading

References

Apr 1, 2009·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Abdel-Mohsen HamadFederico Rea
Oct 14, 2010·General Thoracic and Cardiovascular Surgery·Takahiro MimaeMorihito Okada
May 2, 2013·Interactive Cardiovascular and Thoracic Surgery·Motoki YanoKatsuhiro Okuda
Oct 17, 2013·World Journal of Surgery·Motoki YanoYu Hikosaka

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Citations

Mar 13, 2021·Seminars in Thoracic and Cardiovascular Surgery·Sota YoshimineKimikazu Hamano
Apr 3, 2021·Monaldi Archives for Chest Disease = Archivio Monaldi Per Le Malattie Del Torace·Dario AmoreCarlo Curcio

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