J Vet Sci.  2007 Dec;8(4):393-399. 10.4142/jvs.2007.8.4.393.

Comparison of different bronchial closure techniques following pneumonectomy in dogs

• Salci H
• Bayram AS
• Ozyigit Z
• Gebitekin
• Gorgul OS

• KMID: 1106220
• DOI: http://doi.org/10.4142/jvs.2007.8.4.393

Abstract

The comparison of the histologic healing and bronchopleural fistula (BPF) complications encountered with three different BS closure techniques (manual suture, stapler and manual suture plus tissue flab) after pneumonectomy in dogs was investigated for a one-month period. The dogs were separated into two groups: group I (GI) (n = 9) and group II (GII) (n = 9). Right and left pneumonectomies were performed on the animals in GI and GII, respectively. Each group was further divided into three subgroups according to BS closure technique: subgroup I (SGI) (n = 3), manual suture; subgroup II (SGII) (n = 3), stapler; and subgroup III (SGIII) (n = 3), manual suture plus tissue flab. The dogs were sacrificed after one month of observation, and the bronchial stumps were removed for histological examination. The complications observed during a one-month period following pneumonectomy in nine dogs (n = 9) were: BPF (n = 5), peri-operative cardiac arrest (n = 1), post-operative respiratory arrest (n = 1), post-operative cardiac failure (n = 1) and cardio-pulmonary failure (n = 1). Histological healing was classified as complete or incomplete healing. Histological healing and BPF complications in the subgroups were analyzed statistically. There was no significant difference in histological healing between SGI and SGIII (p = 1.00; p > 0.05), nor between SGII and SGIII (p = 1.00; p > 0.05). Similarly, no significant difference was observed between the subgroups in terms of BPF (p = 0.945; p > 0.05). The results of the statistical analysis indicated that manual suture, stapler or manual suture plus tissue flab could be alternative methods for BS closure following pneumonectomy in dogs.

Keyword

bronchial closure; bronchial stump; dog; pneumonectomy

MeSH Terms

Animals
Bronchi/cytology/*surgery
Dog Diseases/etiology/prevention & control/*surgery
Dogs
Female
Granulation Tissue/cytology
Heart Failure/etiology/veterinary
Male
Pneumonectomy/adverse effects/methods/*veterinary
Postoperative Complications/prevention & control/veterinary
Surgical Stapling/veterinary
Surgical Wound Dehiscence/veterinary
Suture Techniques/*veterinary

Figure

• 

  Fig. 1 (A) Suture closure of the main stem bronchus (arrow) with 2-0 vicryl following pneumonectomy. (B) Application of a TA-30 stapler to the main stem bronchus after pulmonary artery and vein ligation. (C) Transposition and suturing of the 4th intercostal muscle flap (arrow) to the main stem bronchus following pneumonectomy.

• 

  Fig. 2 (A) Mediastinal shift observed on the 15th postoperative day on a ventrodorsal radiograph of a dog with right pneumonectomy. h: heart. (B) This postmortem ventro-dorsal radiograph shows tension pneumothorax and subcutaneous emphysema (arrow) in a dog with BPF.

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  Fig. 3 Bronchial dehiscence as a necropsy finding of a dog with BPF. bs: bronchial stump, m: pedicled intercostal externus- internus muscle.

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  Fig. 4 (A) Granulation tissue formation and continuing phagocytosis of the suture material in subgroup I (manual suture). (B) Granulation tissue around the BS and stapler particles surrounded by macrophages in subgroup II (stapler). (C) Granulation tissue forming around the BS covered with muscle tissue in subgroup III (manual suture plus tissue flab). gt: granulation tissue, m: muscle tissue, mc: macrophages, s: suture material, sp: stapler particles, arrow: new vessel formation. H&E stain, ×200 (A&C), ×100 (B).

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