Tomizawa Kenji, Oiki Hana, Fukuda Shota, Nishino Masaya, Sato Katsuaki, Mitsudomi Tetsuya
Division of Thoracic Surgery, Department of Surgery, Izumi City General Hospital, Izumi, Osaka, Japan.
Division of Thoracic Surgery, Department of Surgery, Faculty of Medicine, Kindai University, Osakasayama, Osaka, Japan.
Ann Thorac Cardiovasc Surg. 2025;31(1). doi: 10.5761/atcs.oa.25-00031.
Motorized automatic staplers are used for bronchial closure following pulmonary resection. This study aimed to compare the completeness of staple formation in bronchial closure using 2 commonly adopted staple cartridges with motorized automatic staplers as follows: graduated-height staples (GHS) and equal-height staples (EHS).
This prospective observational study included 103 patients (105 bronchial stumps) undergoing pulmonary resections for lung cancer. Resected bronchi were embedded in paraffin, X-rays were taken, and staple formations were scored on a 0-4 scale, with a score of 4 indicating complete staple formation. Stump scores represented the average score of all staples per bronchial stump.
The GHS exhibited a higher incidence of staple scores above the median (3.91) than that of the EHS (37/59 [62.7%] vs. 19/46 [41.3%], respectively; p = 0.033). Additionally, the GHS had a higher rate of complete staple formation than that in the EHS (84.7% vs. 75.1%; p <0.0001). This difference was more evident in calcified bronchi (84.2% vs. 57.6%, respectively; p <0.0001). No bronchopleural fistula was observed in any patients during the year.
Staple formations were generally more complete in the GHS than in the EHS. This difference was particularly notable in calcified bronchi.
电动自动吻合器用于肺切除术后的支气管闭合。本研究旨在比较使用两种常用的电动自动吻合器钉仓进行支气管闭合时钉合的完整性，这两种钉仓分别为：渐高型钉（GHS）和等高型钉（EHS）。
这项前瞻性观察性研究纳入了103例接受肺癌肺切除术的患者（105个支气管残端）。将切除的支气管嵌入石蜡中，进行X线检查，并对钉合情况进行0至4分的评分，4分表示钉合完全。残端评分代表每个支气管残端所有吻合钉的平均评分。
GHS高于中位数（3.91）的钉合评分发生率高于EHS（分别为37/59 [62.7%] 对19/46 [41.3%]；p = 0.033）。此外，GHS的完全钉合形成率高于EHS（84.7%对75.1%；p <0.0001）。这种差异在钙化支气管中更为明显（分别为84.2%对57.6%；p <0.0001）。在这一年中，未观察到任何患者发生支气管胸膜瘘。
GHS的钉合通常比EHS更完整。这种差异在钙化支气管中尤为显著。
