Potaris Konstantinos, Kapetanakis Emmanuil, Papamichail Konstantinos, Midvighi Elena, Verveniotis Alexis, Parissis Fotios, Apostolou Demetrios, Tziortziotis Vaios, Maimani Spiridoula, Pouliara Evangelia, Vogiatzis Gregorios, Kakaris Stamatis, Konstantinou Marios
b General Hospital Sotiria, Athens, 115 27, Greece.
c Department of Thoracic Surgery, Sotiria General Hospital, Athens, GR.
Int Surg. 2015 Jul 27. doi: 10.9738/INTSURG-D-15-00116.1.
AbstractObjective: During fiscal crisis there was a period of shortage of staplers in our hospital, which drove us to manual suturing of bronchi and pulmonary vessels during major lung resections. We present our experience during that period in comparison to a subsequent period when staplers became available again.
A total of 256 lobectomies and 78 pneumonectomies were performed using manual suturing (group A), between September 2009 and September 2010, and compared regarding surgical outcome to 248 lobectomies and 60 pneumonectomies using staplers (group B), between September 2011 and September 2012.
Although we did not observe statistically significant differences but only a trend towards less operative time, for both lobectomies (p=0.21) and pneumonectomies (p=0.31), we actually noted a 41 and 47 minutes saving of operative time using staplers (group B), in comparison to manual suturing (group A). We also observed a trend towards less morbidity rates in patients of group B, who underwent lobectomy (10.48%), and pneumonectomy (20%), versus patients of group A, who underwent lobectomy (15.62%), and pneumonectomy (30.76%); we did not observe any substantial differences in the other surgical outcome variables, and in patients' demographics comorbidities, and anatomic allocation of surgical procedures performed.
The use of staplers offers safety with secure bronchial or vascular sealing, and saving of operative time. Their unavailability at an interval during fiscal crisis although it did not affect surgical outcome, revealed their usefulness and value.
摘要目的：在财政危机期间，我院出现吻合器短缺，这促使我们在进行大型肺切除手术时采用支气管和肺血管的手工缝合。我们将呈现该时期的经验，并与随后吻合器再次可用时的时期进行比较。
2009年9月至2010年9月期间，共进行了256例肺叶切除术和78例全肺切除术，采用手工缝合（A组），并将手术结果与2011年9月至2012年9月期间使用吻合器进行的248例肺叶切除术和60例全肺切除术（B组）进行比较。
尽管我们未观察到统计学上的显著差异，仅发现手术时间有缩短的趋势，无论是肺叶切除术（p = 0.21）还是全肺切除术（p = 0.31），但实际上与手工缝合（A组）相比，使用吻合器（B组）在肺叶切除术和全肺切除术中分别节省了41分钟和47分钟的手术时间。我们还观察到B组接受肺叶切除术（10.48%）和全肺切除术（20%）的患者与A组接受肺叶切除术（15.62%）和全肺切除术（30.76%）的患者相比，发病率有降低的趋势；我们未观察到其他手术结果变量、患者人口统计学合并症以及所实施手术的解剖分布方面存在任何实质性差异。
使用吻合器可提供安全保障，实现可靠的支气管或血管封闭，并节省手术时间。在财政危机期间的一段时间内吻合器不可用，尽管这未影响手术结果，但显示出了它们的实用性和价值。
