Murray Kevin D, Ho Chih-Hsiang, Hsia Jiun-Yi James, Little Alex G
Department of Surgery, University of Nevada School of Medicine, 2040 W. Charleston Boulevard, Suite 601, Las Vegas, NV 89102, USA.
Chest. 2002 Dec;122(6):2146-9. doi: 10.1378/chest.122.6.2146.
Although uncommon, prolonged postoperative air leaks are a troublesome complication of lung surgery. This study was performed to determine if buttressing pulmonary staple lines would reduce air leakage at varying airway pressures, and if there was a difference between buttressing materials.
Using cadaver lungs, the development of air leak from staple lines was evaluated at incremental airway pressures. Unreinforced staples were compared to staples reinforced with bovine pericardium and staples reinforced with expanded polytetrafluorethylene (ePTFE).
Unreinforced staple lines began to leak air at an airway pressure of 20 mm Hg, and > 90% leaked at a pressure of 35 mm Hg. Both bovine pericardium and ePTFE significantly reduced the incidence of air leak at these airway pressures. At higher airway pressures, ePTFE was superior to bovine pericardium.
Staple line reinforcement with either material protects against air leak. Patients at risk for elevated airway pressures and/or postoperative ventilator support should be considered for utilization of these staple reinforcing materials.
尽管术后长时间漏气并不常见，但却是肺手术中一个棘手的并发症。本研究旨在确定加固肺吻合钉线是否能在不同气道压力下减少漏气，以及加固材料之间是否存在差异。
使用尸体肺，在递增的气道压力下评估吻合钉线漏气情况。将未加固的吻合钉与用牛心包加固的吻合钉以及用膨体聚四氟乙烯（ePTFE）加固的吻合钉进行比较。
未加固的吻合钉线在气道压力为20 mmHg时开始漏气，在35 mmHg压力下> 90%会漏气。牛心包和ePTFE在这些气道压力下均显著降低了漏气发生率。在更高的气道压力下，ePTFE优于牛心包。
用这两种材料加固吻合钉线均可防止漏气。对于有气道压力升高风险和/或术后需要呼吸机支持的患者，应考虑使用这些吻合钉加固材料。
