Summary
After lobectomy and pneumonectomy in experimental evaluations stapled bronchial closures showed the lowest incidence of inflammatory reaction and the highest strength determined by leakage pressure compared with other suture material. A total of 233 lung resections - performed at Surgical University Clinic Köln-Lindenthal and the Clinic for General and Abdominal Surgery of the Johannes-Gutenberg-Universität Mainz — were reviewed. Mechanical stapling reduced the rate of bronchopleural fistulas to 2.0% compared with 7.1 % after manual suturing. In parallel, mortality related to bronchial stump leakage decreased to 0.7%. Main advantages of bronchial closure with staplers are the simplicity of their use, the speed and the uniformity of the closure. Thereby stapling devices are valuable completions in pulmonary surgery.
Zusammenfassung
Experimentelle Untersuchungen haben für den maschinellen Bronchusverschluß nach Lobektomie und Pneumonektomie im Vergleich zu anderen Nahtmaterialien die geringste Entzündungsrate und die höchste Zugfestigkeit ergeben. In einer konsekutiven Serie von 233 Lungenresektionen der Chirurgischen Kliniken Köln-Lindenthal und der Klinik für Allgemein- und Abdominalchirurgie der Johannes Gutenberg-Universität Mainz ging die Häufigkeit einer Bronchus-stumpfinsuffizienz von 7,1% nach manuellem Bronchusverschluß auf 2,0% und die insuffizienzbedingte Letalität auf 0,7% bei Anwendung des Klammergeräts zurück. Die wesentlichen Vorteile des maschinellen Bronchusverschlusses sind die Einfachheit der Anwendung, die Schnelligkeit und die Gleichmäßigkeit des Verschlusses. Damit stellen die Klammernahtgeräte bei Lungenresektionen eine wertvolle Ergänzung der Operationstechnik dar.
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Junginger, T., Walgenbach, S. & Pichlmaier, H. Maschineller und manueller Bronchusverschluß —ergebnisse einer konsekutiven untersuchungsserie. Langenbecks Arch Chiv 374, 323–328 (1989). https://doi.org/10.1007/BF01262810
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DOI: https://doi.org/10.1007/BF01262810