Preventive esophagomyobronchoplasty as a method to prevent the failure of the bronchial stump in pneumonectomy for lung cancer
- Authors: Sulimanov RA1, Sulimanov RR1, Spassky ES1, Fedorova TV1, Kholodova MA1
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Affiliations:
- Yaroslav-the-Wise Novgorod State University
- Issue: Vol 102, No 6 (2021)
- Pages: 940-945
- Section: Clinical experiences
- URL: https://journal-vniispk.ru/kazanmedj/article/view/89781
- DOI: https://doi.org/10.17816/KMJ2021-940
- ID: 89781
Cite item
Abstract
Aim. Comparative analysis of insufficiency rate of bronchial stump sutures in pneumonectomy for lung cancer, depending on suturing techniques.
Methods. A patented technique for bronchial stump suturing has been introduced into the practice of the GOBUZ clinic “Novgorod Regional Clinical Hospital” based on the Department of thoracic surgery since 2015 for pneumonectomy for lung cancer. Before the introduction of the developed technique, various generally accepted methods of bronchial stump forming were used (mechanical suture, manual suture, their combination, bronchial stump coverage with mediastinal pleura, pericardial flap). A retrospective analysis of 173 case histories and operational protocols of patients with lung cancer who underwent pneumonectomy was carried out for the failure of bronchial stump sutures when using conventional suturing techniques between 2010 and 2014 (the first group of patients). We also performed a retrospective and prospective analysis of 204 case histories and operational protocols of patients in a similar clinical group when using a patented suturing technique between 2015 and 2020 (the second group of patients). Statistical analysis was carried out by using Statistica 10.0 software (StatSoft, Inc. 2011). The qualitative and quantitative indicators were analyzed by using the Pearson’s χ2-test with Yates’s correction.
Results. A retrospective analysis shows that the failure rate in the use of generally accepted bronchial stump suturing techniques for 2010–2014 was 10.4%. After the implementation of the method of preventive esophagobronchomyoplasty, complications as bronchial stump suture failure were not detected in any case between 2015 and 2020.
Conclusion. The study shows high efficiency, a decrease in the incidence of complications as the failure of bronchial stump sutures in the use of the developed method of preventive esophagomyobronchoplasty in pneumonectomy for lung cancer.
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##article.viewOnOriginalSite##About the authors
R A Sulimanov
Yaroslav-the-Wise Novgorod State University
Author for correspondence.
Email: sulimanov@mail.ru
Russian Federation, Veliky Novgorod, Russia
R R Sulimanov
Yaroslav-the-Wise Novgorod State University
Email: sulimanov@mail.ru
Russian Federation, Veliky Novgorod, Russia
E S Spassky
Yaroslav-the-Wise Novgorod State University
Email: sulimanov@mail.ru
Russian Federation, Veliky Novgorod, Russia
T V Fedorova
Yaroslav-the-Wise Novgorod State University
Email: sulimanov@mail.ru
Russian Federation, Veliky Novgorod, Russia
M A Kholodova
Yaroslav-the-Wise Novgorod State University
Email: sulimanov@mail.ru
Russian Federation, Veliky Novgorod, Russia
References
- Davydov M.I., Aksel E.M. The incidence of malignant neoplasms in the po¬pulation of Russia and the CIS countries in 2007. Journal of N.N. Blokhin Russian Cancer Research Center RAMS. 2009; 20 (3 S1): 52–90. (In Russ.)
- Trahtenberg A.H., Chissov V.I. Rak legkogo. Atlas. (Lung cancer. Atlas.) М.: GEOTAR-Media. 2009; 656 р. (In Russ.)
- Bisenkov L.N., Bikhodzhin R.Sh. Prophylaxis and treatment of primary insufficiency of bronchial stump after pneumonectomy. Khirurgiya. Zhurnal im. N.I. Pirogova. 2007; (1): 59–62. (In Russ.)
- Deslauriers J., Ferraro P. Late complications. Eds F.G. Pearson, G.A. Patterson, J.D. Cooper, A.E.M.R. Lerut, J.D. Luketich, T. W. Rice. New York. 2006; 189–205.
- Cerfolio R.J. The incidence, etiology and prevention of postresectional bronchopleural fistula. Semin. Thorac. Cardiovasc. Surg. 2001; 13 (1): 3–7. doi: 10.1053/stcs.2001.22493.
- Darling G.E., Abdurahman А., Yi Q.L. Risk of right pneumonectomy: role of bronchopleural fistula. Ann. Thorac. Surg. 2005; 79 (2): 433–437. doi: 10.1016/j.athoracsur.2004.07.009.
- Rudin Je.P., Birgin S.H. Sposoby zakrytija kul'ti bronha pri rezekcii legkih. (Closure Methods for the bronchus stump in lung resection.) M.: Minzdrav SSSR. 1990; 35 р. (In Russ.)
- Amasura H., Kondo H., Thuchia R. Management of bronchial stump in pulmonary resection: a review of 533 consecutive recent bronchial closures. Eur. J. Cardio-Thorac. Surg. 2000; 17 (2): 106–110. doi: 10.1016/S1010-7940(00)00318-3.
- Cardillo G., Galetta D., Schil P., Zuin A., Filosso P., Cerfolio R., Forcione A.R., Carleo F. Completion pneumonectomy: a multicen international study on 165 patients. Eur. J. Cardio-Thorac. Surg. 2012; 42 (3): 405–409. doi: 10.1093/ejcts/ezs063.
- Sonobe M., Nakagawa M., Ichinose M., Ikegami N., Nagasawa M., Shindo T. Analysis of risk factors in bronchopleural fistula after pulmonary resection for primary lung cancer. Eur. J. Cardio-Thorac. Surg. 2000; 18 (3): 519–523. doi: 10.1016/S1010-7940(00)00541-8.
- Chichevatov D.A. Diafragmal'nyj i sal'nikovyj loskuty v grudnoj hirurgii. (Diaphragmatic and omental flaps in thoracic surgery.) SPb.: ELBI-SPb. 2013; 144 р. (In Russ.)
- Sinev E.N., Chichevatov D.A. Sleeve lobectomy with uttermost resection of the bronchial trunk. Povolzhskiy onkologicheskiy vestnik. 2015; (1): 31–36. (In Russ.)
- Zjurina Yu.V., Sulima¬nov R.A. Seeking opportunities for prevention of bronchial stump sutures failure. The Journal of scientific articles “Health & education millennium”. 2017; 19 (3): 51–54. (In Russ.)
- Sulimanov R.A., Zjurina Ju.V., Sulimanov R.R., Bondarenko S.V., Spasskij E.S. Method of preventing bronchial stump failure after pulmonectomy. Patent for invention RF No. 2617882. Bulletin issued at 28.04.2017. (In Russ.)
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