Document Detail


Functional assessment of a new staple line reinforcement in lung resection.
MedLine Citation:
PMID:  16129450     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A major complication of lung resection is prolonged leaking at the staple line. Staple-line reinforcement is performed routinely during these procedures using bovine pericardium (peri-strips) and expanded polytetrafluorethylene. Both materials have been shown previously to increase staple-line durability and reduce the overall incidence of prolonged air leaking after lung resection, specifically in lung volume-reduction surgery. Small intestinal submucosa (SIS) has had many applications in human tissues consequent to its absorption and healing profile, which are well documented in human and animal models. However, it had not been studied in reinforcement of pulmonary staple lines. MATERIALS AND METHODS: We hypothesized that SIS reinforcement of staple lines in healthy lung tissue would increase durability, as determined by leak rates at increased airway pressures as compared to nonreinforced staple lines. Eight healthy juvenile Yorkshire-cross pigs were subjected to bilateral apical lung resections; one side was reinforced with SIS. The lungs were then inflated to sequentially increase intrabronchial pressures (5-75 cm H2O) for 60-second intervals while the chest was filled with saline under direct visualization monitoring for air leak. RESULTS: Staple lines reinforced with porcine small intestinal submucosa had significantly better durability as determined by Kaplan-Meier survival calculations with respect to leak rate as a function of pressure. CONCLUSION: Reinforcement of staple lines with SIS allows pulmonary staple lines to tolerate significantly higher intrabronchial pressures without demonstrating air leak at the staple line.
Authors:
Douglas M Downey; Michael Michel; Joseph G Harre; Jerry W Pratt
Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2005-08-29
Journal Detail:
Title:  The Journal of surgical research     Volume:  131     ISSN:  0022-4804     ISO Abbreviation:  J. Surg. Res.     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-02-14     Completed Date:  2006-03-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376340     Medline TA:  J Surg Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  49-52     Citation Subset:  IM    
Affiliation:
Department of Surgery, Keesler Medical Center, Keesler Air Force Base, Keesler, Mississippi, USA.
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MeSH Terms
Descriptor/Qualifier:
Air
Animals
Intestinal Mucosa
Lung / surgery*
Pressure
Sutures*
Swine

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