Tracheobronchial sleeve resection with the use of a continuous anastomosis: Results of one hundred consecutive cases

Kutlu, Cemal Asım; Goldstraw, Peter

doi:10.1016/s0022-5223(99)70247-3

Cited by 67 publications

(39 citation statements)

References 22 publications

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“…In this study we investigated three frequently described suturing techniques: A continuous suture with a nonabsorbable monofilament material (polypropylene), a single interrupted suture with multifilament (polyglactin 910) and a monofilament (polydioxanone) suture. These materials and techniques are not only a selection from literature, but also represent the personal taste and experience of outstanding experts [9,[16][17][18][27][28][29][30].…”

Section: Discussionmentioning

confidence: 99%

Breaking Strength of Native and Sutured Trachea

Behrend¹,

Kluge²,

Schüttler³

et al. 2001

Eur Surg Res

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Tracheal anastomoses are, even more so than other sutures, often only possible to prepare under tension and thus in danger of breakage. No information is available regarding native tracheae and freshly sutured tracheae. For this reason, our objective was to examine the tensile strength of native tracheae and compare it with freshly sutured specimens. Fresh tracheae were collected from the local slaughterhouse within 30 min of slaughter. With the help of a suitable holding device, 24 fresh tracheae were mounted on a material testing machine and stretched to breaking point, during which the force and distance required were recorded. The same study was carried out on each 10 freshly anastomosed tracheae using three different suturing techniques. The mean value of the maximum force required for native tracheae was 198 N. With continuous suturing (polypropylene), a mean value of 171 N was attained, and with single interrupted suturing (polydioxanone and polyglactin 910), 123 N, respectively, 108 N. Differences between the groups proved to be highly significant. With respect to the mechanical strain from traction, the continuous suture proved to be statistically identical to native tracheae, whereas single interrupted sutures revealed a considerably lower stability under burden. Therefore, the continuous suture is of advantage in respect of the mechanical strain from traction and the suture protection of tracheal anastomoses. Further studies with differing survival times in vivo with this method provide insight into the stability of tracheal anastomoses during the healing process.

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Section: Discussionmentioning

confidence: 99%

Breaking Strength of Native and Sutured Trachea

Behrend¹,

Kluge²,

Schüttler³

et al. 2001

Eur Surg Res

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“…These materials and techniques are not only a selection from existing literature, but also represent the personal preference and experience of outstanding experts [3,10,14,17,[30][31][32][33].…”

Section: Discussionmentioning

confidence: 99%

Influence of Suture Material and Technique on End-to-End Reconstruction in Tracheal Surgery: An Experimental Study in Sheep

Behrend¹,

Klempnauer²

2001

Eur Surg Res

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Resection and end-to-end anastomosis of the trachea represent the preferred treatment for various benign and malignant diseases involving the trachea. Various studies have reported conflicting results with alternative techniques and suture materials for tracheal anastomosis. Our objective was to evaluate three frequently used techniques concerning stenosis rate and histological reaction in a large-animal species. Tracheal resection of 3 cm and end-to-end anastomosis were performed in 15 sheep with the use of three different techniques. In the first group, an interrupted suture with polyglactin, in the second group an interrupted suture with polydioxanone, and in the last group a continuous suture with polypropylene were used. The animals were killed 1, 2, 4, 8, and 24 weeks postoperatively. The luminal stenosis was determined by means of computerized planimetry. All three techniques appeared to be appropriate for tracheal anastomosis. The luminal stenosis developed within the first 8 weeks after surgery. A cross-sectional area of approximately 40–70% was finally achieved. Differences dependent on the suture material are less important than the technical details of the operation.

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“…Although interrupted sutures are widely applied, twisting of the suture threads frequently occurs; this often breaks the continuity of the operation and prolongs the operative time for unskilled surgeons. Continuous sutures are considered easy to perform, and the clinical results are comparable with those of reported series using interrupted sutures for tracheal and bronchial anastomosis (14). However, Li et al (10) believed that tightening the sutures may lead to anastomotic leakage or, in the worst-case scenario, anastomotic dehiscence.…”

Section: Discussionmentioning

confidence: 67%

Modified bronchial anastomosis in video-assisted thoracoscopic sleeve lobectomy: a report of 32 cases

Chen

Huang

et al. 2016

J. Thorac. Dis.

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Background: Bronchial anastomosis is a key technical challenge in sleeve lobectomy, especially when using the video-assisted thoracoscopic surgery (VATS) approach. A retrospective study was conducted to evaluate the feasibility and safety of a modified bronchial anastomosis technique developed by the authors at Fujian Union Hospital.Methods: From October 2010 to October 2015, we performed 32 cases of VATS sleeve lobectomy through a three-port or single-port approach. All bronchial anastomoses were performed using modified bronchial anastomosis technique: the bronchial anastomosis was begun with an initial stitch on the posterior wall, and the bilateral quarters of the circumference were continuously sutured. The other two bilateral quarters were then similarly sutured, and the last knot was made outside the bronchial lumen.Results: All cases were completed uneventfully. No perioperative deaths or serious complications occurred.The mean operative time, bronchial anastomosis time, and blood loss volume were 271.8±67.5, 37.6±12.0 min, and 177.5±102.9 mL, respectively. The mean follow-up time was 21.0±11.7 months, and the follow-up rate was 96.9% (31/32). An electronic bronchoscope scan was performed 6 months after surgery, and a fine healing stoma was detected in all cases. No anastomotic fistula, anastomotic stenosis, or other serious postoperative anastomotic complications occurred until the end of follow-up.Conclusions: Modified bronchial anastomosis technique applied in bronchial anastomosis was safe and feasible in three-port and single-port VATS sleeve lobectomy with good short-term and long-term therapeutic results. Adequate management of the operative process and implementation of a skilled bronchial anastomosis technique could help to reduce the difficulty of VATS sleeve lobectomy.

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Tracheobronchial sleeve resection with the use of a continuous anastomosis: Results of one hundred consecutive cases

Abstract: Our experience suggests that the results of continuous suture technique are comparable with those from reported series using interrupted suture technique for tracheal and bronchial anastomosis.

Cited by 67 publications

References 22 publications

Breaking Strength of Native and Sutured Trachea

Breaking Strength of Native and Sutured Trachea

Influence of Suture Material and Technique on End-to-End Reconstruction in Tracheal Surgery: An Experimental Study in Sheep

Modified bronchial anastomosis in video-assisted thoracoscopic sleeve lobectomy: a report of 32 cases

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