Pericardial Conduit for Pulmonary Artery Reconstruction by Surgical Stapling

doi:10.1016/j.athoracsur.2016.11.073

The Annals of Thoracic Surgery

Volume 103, Issue 5, May 2017, Pages e469-e471

https://doi.org/10.1016/j.athoracsur.2016.11.073 Get rights and content

Pulmonary artery reconstruction in lung cancer surgery is an effective surgical method to avoid pneumonectomy that leads to longer survival times with few adverse effects. The pericardium is often used for the interposition of a prosthetic conduit. A pericardial conduit can be easily and precisely constructed by surgical stapling, which facilitates pulmonary artery reconstruction. In this report, the process and pitfalls of surgical stapling are described.

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Technique

Sleeve lobectomy with pulmonary artery reconstruction in response to tumor invasion of the pulmonary artery is described in this report. Conventional thoracotomy is first performed. A fissure is created by surgical linear stapling, and the pulmonary vein and bronchus are divided using a surgical stapler. Peripheral branches of the pulmonary artery that can be transected should be divided. The pulmonary artery in the area where the tumor has invaded is encircled as closely as possible. The

Comment

Sleeve lobectomy is recommended in lung cancer surgery instead of pneumonectomy, which should be avoided if at all possible [1]. Pulmonary artery reconstruction during sleeve lobectomy is a safe and effective procedure, and reports have described extended survival rates 2, 3, 4.

Combined resection of the pulmonary artery is performed in 3.2% to 3.6% of lobectomies in lung cancer surgery 3, 4. Although few cases are reported, investigators have noted that 2.7% to 2.9% of pulmonary artery

References (7)

D. Galetta et al.
Surgical techniques and long-term results of pulmonary artery reconstruction in patients with lung cancer
Ann Thorac Surg
(2015)
F. Venuta et al.
Reconstruction of the pulmonary artery for lung cancer: long-term results
J Thorac Cardiovasc Surg
(2009)
E.A. Rendina et al.
Sleeve resection and prosthetic reconstruction of the pulmonary artery for lung cancer
Ann Thorac Surg
(1999)

There are more references available in the full text version of this article.

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Pulmonary artery resection with autologous pericardial conduit to avoid pneumonectomy in lung neoplasms surgery: How to do it
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A biodegradable magnesium surgical staple for colonic anastomosis: In vitro and in vivo evaluation
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Citation Excerpt :
At present, the proportion of suture staples in surgery has increased year by year, especially in the application of endoscopic surgery [54]. In addition to the gastrointestinal tract, suture staples can also be widely applied for pulmonary anastomosis [55], bronchial anastomosis [56,57], and esophagogastric anastomosis [58]. Therefore, more exploration works of biodegradable staples are still needed in the future.
Staplers have been widely used in the clinical treatment of gastrointestinal reconstruction. However, the current titanium (Ti) staple will remain in the human body permanently, resulting in some adverse effects. In this study, we developed a type of biodegradable staple for colonic anastomosis using 0.3 mm diameter magnesium (Mg) alloy wires. The wire surface was modified by micro-arc oxidation treatment (MAO) and then coated with poly-l-lactic acid (PLLA) to achieve a moderate degradation rate matching the tissue healing process. The results of tensile tests on isolated porcine colon tissue anastomosed by Mg and Ti staples showed that the anastomotic property of Mg staples was almost equal to that of Ti staples. The in vitro degradation tests indicated the dual-layer coating effectively enhanced the corrosion resistance and maintained the tensile force of the coated staple stable after 14-day immersion in the simulated colonic fluid (SCF). Furthermore, 24 beagle dogs were employed to conduct a comparison experiment using Mg-based and clinical Ti staples for 90-day implantation by ent-to-side anastomosis of the colon. The integrated structure of Mg-based staples was observed after 7 days and completely degraded after 90 days. All animals did not have anastomotic leakage and stenosis, and 12 dogs with Mg-based staples fully recovered after 90 days without differences in visceral ion levels and other side effects. The favorable performance makes this Mg-based anastomotic staple an ideal candidate for colon reconstruction.
Successful pulmonary artery stenting for occlusion at a constructed pericardial conduit after right upper double sleeve lobectomy
2022, General Thoracic and Cardiovascular Surgery
Pulmonary artery “conduit” reconstruction using bovine pericardium following long-segment sleeve resection: a unique “in situ tailor-made” sewing method
2020, General Thoracic and Cardiovascular Surgery

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How to do itPericardial Conduit for Pulmonary Artery Reconstruction by Surgical Stapling

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Ann Thorac Surg

J Thorac Cardiovasc Surg

Ann Thorac Surg

How to do it
Pericardial Conduit for Pulmonary Artery Reconstruction by Surgical Stapling