Pulmonary resection using automatic stapling devices.

Between January 1980 and December 1986, 674 patients underwent pulmonary surgery at this institution under the supervision of one surgeon (RJD). Automatic stapling devices were used to close the bronchus in all but 12 patients. Malignant disease was the reason for 85% of resections. The operative mortality was 4.9% (3.2% in patients undergoing lobectomy and 8.3% in those undergoing pneumonectomy). The complication rate was 17.3%. Bronchopleural fistula (BPF) occurred in 11 patients, an incidence of 1.7%. The post-pneumonectomy incidence of BPF was 2.7% within 3 months of surgery and 4.5% overall. Stapled closure of one or more hilar vessels was employed in 153 patients. The role of staplers in pulmonary surgery with particular reference to the incidence of bronchopleural fistula is examined.