Tracheal anastomosis with new synthetic monofilament absorbable sutures.

Muramatsu, Takashi; Ohata, M; Iida, Midori; Ohmori, Kazuo; Irako, Mitumasa; Kïtamura, Kazuo; Nakamura, Suguru; Ogasawara, Kouji; Namiki, Y; Nishimura, Osamu; 不二夫, 長坂; Koga, Mamoru; Sezai, Yukiyasu

doi:10.2995/jacsurg1987.6.104

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“…The absorbable suture, which was used in the present case, is safe because the tensile strength is maintained for 2 weeks until the anastomosis site and bronchial stump are covered by connective tissue, although there is a concern for suture failure owing to an early decrease in tensile strength [8]. In the present case, there had been no air leakage from the bronchial stump.…”

Section: Discussionmentioning

confidence: 85%

Obstructive pneumonia owing to migration of a Teflon pledget at 8 years after surgery for a pulmonary carcinoid tumor: a case report

2019

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BackgroundIt is uncommon for a bronchial stump-related complication to develop during the remote postoperative period in a case of obstructive pneumonia owing to migration of the suture material. Here, we describe a case of bronchial obstructive pneumonia that developed owing to migration of the suture material in the airway 8 years after pulmonary resection.Case presentationA 34-year-old woman underwent left lower lobectomy for a pulmonary carcinoid tumor (pT1bN0M0-stage IA) in 2010. She experienced obstructive pneumonia, and chest computed tomography revealed a mass protruding from the bronchial stump to the bronchial lumen in 2018. After treatment for pneumonia, flexible bronchoscopy showed the presence of a fibrous suture material (Teflon pledget) completely obstructing the left second carina. A week later, the Teflon pledget obstructing the bronchial lumen was removed using a flexible bronchoscope with the patient under general anesthesia. The procedure was completed without removing the small amount of granulation tissue because the bronchial lumen opened after removing the Teflon pledget. She has remained asymptomatic for 1 year after removal.ConclusionsIn this case, the complication of obstructive pneumonia developed owing to migration of the non-absorbable suture materials used to suture the bronchial stump. Bronchoscopic management of this rare complication comprised endobronchial removal with the patient under general anesthesia. Given our experience with this case, we believe that such conservative management should allow for excellent results in most instances and avoid the need for reoperation.

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Section: Discussionmentioning

confidence: 85%