gms | German Medical Science

Introduction: Sleeve resections offer parenchyma-sparing alternatives to pneumonectomy in patients with centrally located lung cancer. Though it is a modern standard procedure, there is no consensus on the optimal bronchial suture material and technique. The aim of this study was to compare two suture materials and techniques in patients with complete bronchial sleeve resections.

Material and methods: We retrospectively analysed records of 85 patients who underwent bronchial sleeve lobectomy between January 2002 and December 2011. Data included type of operation, suture material (Vicryl vs. PDS) and technique (interrupted stitch vs. continuous), and post-operative complications. Chi-square and Fisher’s exact test were used to compare suturing materials and techniques with respect to complications. A p-value < 0.05 was considered statistically significant.

Results: In 85 patients (age 64.4±12.8 years; 72.9% male) 74 bronchial and 11 bronchovascular sleeve lobectomies were performed. Continuous and interrupted stitch suture techniques were used in 52 (61.2%) and 33 patients (38.8%), respectively. PDS was used in 56 patients, Vicryl in 29. Post-operative complications were recorded in 22 patients (13 PDS vs. 9 Vicryl, p=0.435; 12 continuous vs. 10 interrupted, p=0.459) with no difference with respect to suturing material or technique: bronchopleural fistulas (n=4; 3 PDS+continuous vs. 1 Vicryl+interrupted, p=0.999 for both), atelectasis (n=10; 6 PDS vs. 4 Vicryl, p=0.729; 6 continuous vs. 4 interrupted, p=0.999), empyema (n=3; 2 PDS vs. 1 Vicryl, p=0.999; 1 continuous vs. 2 interrupted, p=0.560), emphysema (n=2; 1 PDS+continuous vs. 1 Vicryl+interrupted, p=0.999 for both) and pneumonia (n=6; 3 PDS vs. 3 Vicryl, p=0.406; 3 continuous vs. 3 interrupted, p=0.673). All patients survived a 30-day post-operative follow-up period.

Conclusion: Bronchial sleeve resection is a safe method in the treatment of bronchial malignancies independent of the suture technique and material used.