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Thorac Cardiovasc Surg 1997; 45(3): 131-133
DOI: 10.1055/s-2007-1013704
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© Georg Thieme Verlag Stuttgart · New York

The Best Site for Bronchial Stapling in Left and Right Upper Lobectomies: a Comparative Study

H. Akamatsu, M. Terashima, T. Koike, T. Takizawa, Y. Kurita1
  • Department of Respiratory and Cardiovascular Surgery, Niigata Cancer Center Hospital, Niigata, Japan
  • 1Department of Internal Medicine, Niigata Cancer Center Hospital, Niigata, Japan
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Publication History

1997

Publication Date:
19 March 2008 (online)

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Abstract

Bronchial stapling and postoperative bronchoscopy was performed in 22 left upper lobectomies (LUL) and 18 right upper lobectomies (RUL). Seven LUL cases and 15 RUL cases with Staples positioned 2 bronchial rings (BR) from the entrance to the upper lobe bronchus (ULB) had no residual cartilaginous rings at the stump (RCRS). Deformity of the residual bronchus (DRB) was found in 6 of these 7 LUL cases, and 3 of these 15 RUL cases (p < 0.01), with a high rate of suffering from a severe cough. The remaining 15 LUL cases and 3 RUL cases had staples positioned 3 to 4 BR from the entrance to the ULB resulting in one or two RCRS. Only one LUL case with one RCRS was accompanied by DRB and coughing. These facts strongly imply a connection between cough and DRB. DRB was frequently seen in LUL cases with no RCRS (86%), was less likely to occur in cases with one RCRS (10%), and was absent in cases with two RCRS (p < 0.01). We conclude that bronchial staples applied during a LUL should be positioned 3 or 4 bronchial rings distal from the entrance to the left ULB.

Key words

Bronchial stapling - Upper lobe bronchus - Deformity of the residual bronchus - Cough - Residual cartilaginous ring