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Takamori S, Takenaka T, Shimokawa M, Hashinokuchi A, Matsudo K, Nagano T, Kohno M, Miura N, Yoshizumi T. Maximum resistance pressure at the time of lung tissue rupture after porcine lung transection using automatic linear staplers with different reinforcement methods. Surg Today 2024:10.1007/s00595-024-02858-2. [PMID: 38691222 DOI: 10.1007/s00595-024-02858-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 04/08/2024] [Indexed: 05/03/2024]
Abstract
PURPOSES Polyglycolic acid (PGA) sheets, fibrin glue, and staple line reinforcement are frequently used to prevent air leakage during lung resection. However, the optimal staple-line reinforcement method remains unclear. METHODS Cranial lung lobes of pigs were used to evaluate different staple line reinforcement methods (n = 6). Ventilator-assisted manometry was used to measure the maximum resistance pressure at the time of rupture of the lung tissue after stapling. RESULTS The mean maximum resistance pressures at the time of lung tissue rupture after using the stapler alone, stapler with PGA sheet and fibrin glue, and stapler with reinforcement were 38.0 cmH2O, 51.3 cmH2O, and 62.7 cmH2O, respectively. A significant increase in the maximum resistance pressure was observed with stapler reinforcement (P < 0.001), while the differences between the other groups were not statistically significant (P = 0.055, P = 0.111). A histological assessment revealed disruption of alveolar structures near the needle-stitching site in the stapler alone, and in the stapler with PGA sheet and fibrin glue groups. Pleural rupture near the staple line was observed in the stapler with reinforcement group. CONCLUSIONS The maximum resistance pressure before air leakage was significantly higher when using a stapler with reinforcement than when using a stapler alone.
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Affiliation(s)
- Shinkichi Takamori
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
- Faculty of Medicine, Department of Thoracic and Breast Surgery, Oita University, Oita, Japan
| | - Tomoyoshi Takenaka
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Mototsugu Shimokawa
- Department of Biostatistics, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Asato Hashinokuchi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Kyoto Matsudo
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Taichi Nagano
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Mikihiro Kohno
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Naoko Miura
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Tomoharu Yoshizumi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
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Toriguchi K, Kaihara S, Kitamura K, Ishikawa T, Oshima N, Kondo M, Kobayashi H, Hashida H, Uryuhara K. Efficacy of surgical staple line reinforcement in Glissonean stapling: A single-center pilot study. Asian J Endosc Surg 2024; 17:e13293. [PMID: 38452773 DOI: 10.1111/ases.13293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/18/2024] [Accepted: 02/06/2024] [Indexed: 03/09/2024]
Abstract
Vascular staplers are routinely used in laparoscopic liver resection, which has become a standard procedure in advanced medical facilities. Although previous reports have outlined the benefits of staple line reinforcement (SLR), its application in Glissonean pedicle transection during hepatic resection remains poorly studied. This study investigated surgical SLR as a tool to enhance staple line strength and improve perioperative hemostasis. Here, 10 patients who underwent laparoscopic liver resection using the Tri-StapleTM2.0 Reinforced Reload were included. Patient characteristics, surgical details, and outcomes were assessed. The results demonstrated successful outcomes with no complications related to bile leakage or injuries during staple insertion. Overall, our findings suggest that SLR can be safely utilized in Glissonean pedicle transection during laparoscopic liver resections. Further studies are required to comprehensively evaluate its benefits compared with conventional surgical staplers.
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Affiliation(s)
- Kan Toriguchi
- Department of Surgery, Kobe Medical Center General Hospital, Kobe city, Hyogo, Japan
| | - Satoshi Kaihara
- Department of Surgery, Kobe Medical Center General Hospital, Kobe city, Hyogo, Japan
| | - Koji Kitamura
- Department of Surgery, Kobe Medical Center General Hospital, Kobe city, Hyogo, Japan
| | - Tatsuki Ishikawa
- Department of Surgery, Kobe Medical Center General Hospital, Kobe city, Hyogo, Japan
| | - Nobu Oshima
- Department of Surgery, Kobe Medical Center General Hospital, Kobe city, Hyogo, Japan
| | - Masato Kondo
- Department of Surgery, Kobe Medical Center General Hospital, Kobe city, Hyogo, Japan
| | - Hiroyuki Kobayashi
- Department of Surgery, Kobe Medical Center General Hospital, Kobe city, Hyogo, Japan
| | - Hiroki Hashida
- Department of Surgery, Kobe Medical Center General Hospital, Kobe city, Hyogo, Japan
| | - Kenji Uryuhara
- Department of Surgery, Kobe Medical Center General Hospital, Kobe city, Hyogo, Japan
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Yu TC, Huang TC, Chen PY, Shih CC, Chang WW. Biomaterial Material Applications in Postoperative Surgical Fields of Uvulopalatopharyngoplasty: A Comparative Study. J Funct Biomater 2023; 14:337. [PMID: 37504832 PMCID: PMC10381175 DOI: 10.3390/jfb14070337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/15/2023] [Accepted: 06/21/2023] [Indexed: 07/29/2023] Open
Abstract
This retrospective study compared the effectiveness of different materials used in Uvulopalatopharyngoplasty (UPPP) for snoring or obstructive sleep apnea treatment, focusing on the impact on bleeding control, pain control, and healing ability. The study population comprised 213 patients who underwent UPPP at Wan-Fang Hospital between July 2018 and October 2022 divided into four groups based on the postoperative material used: No Material Use Group, Tissue Glue Group, Platelet-Rich Plasma (PRP) Group, and Polyglycolic Acid (PGA) Sheet Group. Results showed significant differences in operation time and intraoperative bleeding amount among the groups, with the Tissue Glue Group demonstrating the shortest operation time. While no significant differences in postoperative pain at 24 h were observed, PRP and PGA Sheet groups exhibited lower average pain scores in cases with higher pain levels. Postoperative complications and emergency room visits due to pain or bleeding varied among the groups, with the No Material Use Group having the highest incidence, although no statistical significance was achieved. This study provides insights into the potential benefits of using advanced materials in UPPP, guiding future research and clinical practice to improve patient care and outcomes.
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Affiliation(s)
- Tsung-Che Yu
- Department of Otolaryngology, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
| | - Ting-Chieh Huang
- Department of Otolaryngology, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
| | - Po-Yueh Chen
- Department of Otolaryngology, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
| | - Chun-Che Shih
- Division of Cardiovascular Surgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
| | - Wei-Wen Chang
- Division of General Surgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
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Rosendorf J, Klicova M, Cervenkova L, Palek R, Horakova J, Klapstova A, Hosek P, Moulisova V, Bednar L, Tegl V, Brzon O, Tonar Z, Treska V, Lukas D, Liska V. Double-layered Nanofibrous Patch for Prevention of Anastomotic Leakage and Peritoneal Adhesions, Experimental Study. In Vivo 2021; 35:731-741. [PMID: 33622866 PMCID: PMC8045053 DOI: 10.21873/invivo.12314] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/17/2021] [Accepted: 01/21/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Anastomotic leakage is a feared complication in colorectal surgery. Postoperative peritoneal adhesions can also cause life-threatening conditions. Nanofibrous materials showed their pro-healing properties in various studies. The aim of the study was to evaluate the impact of double-layered nanofibrous materials on anastomotic healing and peritoneal adhesions formation. MATERIALS AND METHODS Two versions of double-layered materials from polycaprolactone and polyvinyl alcohol were applied on defective anastomosis on the small intestine of healthy pigs. The control group remained with uncovered defect. Tissue specimens were subjected to histological analysis and adhesion scoring after 3 weeks of observation. RESULTS The wound healing was inferior in the experimental groups, however, no anastomotic leakage was observed and the applied material always kept covering the defect. The extent of adhesions was larger in the experimental groups. CONCLUSION Nanofibrous materials may prevent anastomotic leakage but delay healing.
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Affiliation(s)
- Jachym Rosendorf
- Department of Surgery, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic;
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
| | - Marketa Klicova
- Department of Nonwovens and Nanofibrous Materials, Faculty of Textile Engineering, Technical University of Liberec, Liberec, Czech Republic
| | - Lenka Cervenkova
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
- Department of Pathology, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Richard Palek
- Department of Surgery, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
| | - Jana Horakova
- Department of Nonwovens and Nanofibrous Materials, Faculty of Textile Engineering, Technical University of Liberec, Liberec, Czech Republic
| | - Andrea Klapstova
- Department of Nonwovens and Nanofibrous Materials, Faculty of Textile Engineering, Technical University of Liberec, Liberec, Czech Republic
| | - Petr Hosek
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
| | - Vladimira Moulisova
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
| | - Lukas Bednar
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
| | - Vaclav Tegl
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
- Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine in Plzen, Pilsen, Czech Republic
| | - Ondrej Brzon
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
| | - Zbynek Tonar
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
- Department of Histology and Embryology, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
| | - Vladislav Treska
- Department of Surgery, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
| | - David Lukas
- Department of Nonwovens and Nanofibrous Materials, Faculty of Textile Engineering, Technical University of Liberec, Liberec, Czech Republic
- Department of Chemistry, Faculty of Science, Humanities and Education, Technical University of Liberec, Liberec, Czech Republic
| | - Vaclav Liska
- Department of Surgery, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
- Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
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Lee SW, Uchiyama K. A commentary on “Laparoscopic vs. open splenectomy and oesophagogastric revascularisation for liver cirrhosis and portal hypertension: A retrospective cohort study”. Int J Surg 2020; 81:83. [DOI: 10.1016/j.ijsu.2020.07.051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 07/17/2020] [Indexed: 12/13/2022]
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Deguchi H, Tomoyasu M, Shigeeda W, Kaneko Y, Kanno H, Saito H. Reduction of air leakage using linear staple device with bioabsorbable polyglycolic acid felt for pulmonary lobectomy. Gen Thorac Cardiovasc Surg 2019; 68:266-272. [DOI: 10.1007/s11748-019-01207-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 09/09/2019] [Indexed: 11/30/2022]
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Song YN, Qi Y, Zhang CY, Sheng YL, Wu K, Zhu SL, Han L, Shan TT, Ye GC, Zhang QY, Chen YL, Chen JW, Liu YF, Gao LB, Yang Y, He ZF, Zhu DY, Liu DL, Wen FB, Zheng TL, Li JL, Zhao S. A new technology for reducing anastomotic fistula in the neck after esophageal cancer surgery. J Thorac Dis 2019; 11:3084-3092. [PMID: 31463137 DOI: 10.21037/jtd.2019.07.28] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Background To explore the risk factors and prevention methods of cervical mechanical anastomotic fistula and stenosis after the radical resection of esophageal cancer. Methods From March 2018 to November 2018, 128 patients undergoing mechanical anastomosis of esophageal cancer were selected from the Department of Thoracic Surgery of The First Affiliated Hospital of Zhengzhou University. All the enrolled patients were operated on using the Mckeown method, and a retrospective study was conducted. Data for preoperative and postoperative test indices, intraoperative embedding materials, postoperative complications, and preoperative and postoperative treatment were collected, and the relationship between various factors and the incidence of cervical anastomotic fistula and stenosis was analysed. Univariate analysis was conducted using t tests or Fisher's exact probability method, and multivariate analysis was conducted using logistic regression models. Results All 128 patients successfully underwent surgery without dying. The enrolled patients were evaluated using the Stooler classification, with 28 patients having grade 0, 41 patients having grade 1, 34 patients having grade 2, 21 patients having grade 3, and 4 patients having grade 4 stenosis. Patients with stenosis of grade 3 or above had obvious choking sensation, which could only be relieved by balloon dilation. Symptoms in all patients with stenosis were relieved by balloon dilation. There were no significant differences between the two groups regarding embedding materials, preoperative choking history, history of alcohol consumption, history of hypertension, history of coronary heart disease, history of diabetes, postoperative calcium concentration, average albumin concentration, average platelet concentration, body mass index, anastomotic fistula, preoperative chemotherapy, postoperative chemotherapy, or postoperative cough (P>0.05). There were significant differences in postoperative reflux (χ2=11.338, P<0.05) and scar constitution (χ2=12.497, P<0.05). The effects of embedding materials in patients with anastomotic fistula were significantly different (χ2=4.372, P<0.05). Conclusions Postoperative reflux and scar constitution may be risk factors for postoperative anastomotic stenosis after resection of esophageal cancer. There was almost no difference in the effects on esophageal anastomotic stenosis between embedding materials and the omentum majus, but Neoveil® may have certain advantages in preventing cervical anastomotic fistula, and thus may have certain clinical application value.
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Affiliation(s)
- Ya-Nan Song
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Yu Qi
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Chun-Yang Zhang
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Yin-Liang Sheng
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Kai Wu
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Sen-Lin Zhu
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Lu Han
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Ting-Ting Shan
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Guan-Chao Ye
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Qing-Yi Zhang
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Yan-Li Chen
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Jin-Wei Chen
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Ya-Fei Liu
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Lu-Bing Gao
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Yang Yang
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Zhan-Feng He
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Deng-Yan Zhu
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Dong-Lei Liu
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Feng-Biao Wen
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Tian-Liang Zheng
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Ji-Lun Li
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Song Zhao
- Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
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Hayashi K, Motoishi M, Sawai S, Hanaoka J. Hemothorax after emphysematous bullectomy using a linear staple device with bioabsorbable polyglycolic acid felt. J Surg Case Rep 2018; 2018:rjy289. [PMID: 30386552 PMCID: PMC6202508 DOI: 10.1093/jscr/rjy289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 10/18/2018] [Indexed: 11/25/2022] Open
Abstract
A linear stapler with bioabsorbable polyglycolic acid felt is widely used during the resection of emphysematous lung. Currently, an improved staple device with polyglycolic acid felt is being used owing to a history of complications, such as bleeding, that was associated with the previous model. Here, we report a case of a 69-year-old man who presented to our department for treatment of left lower lobe lung cancer using the new staple device. A left lower lobectomy and emphysematous bullectomy were performed. Reoperation was performed following the diagnosis of a postoperative hemothorax. During that operation, a staple with reinforcing material was found to be in contact with the proliferating vessels on the lung surface, resulting in an active bleed. The vessel was cauterized, and the bleeding stopped. This is the first case study to report bleeding associated with the improved staple device.
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Affiliation(s)
- Kazuki Hayashi
- Division of General Thoracic Surgery, Department of Surgery, Shiga University of Medical Science, Setatsukinowa-cho, Otsu, Shiga, Japan
| | - Makoto Motoishi
- Department of Thoracic Surgery, Mitsubishikyoto Hospital, 1 Katsuragosyo-cho, Nishikyo-ku, Kyoto, Japan
| | - Satoru Sawai
- Department of Thoracic Surgery, National Hospital Organization Kyoto Medical Center, Fukakusamukaihata-cho, Fushimi-ku, Kyoto, Japan
| | - Jun Hanaoka
- Division of General Thoracic Surgery, Department of Surgery, Shiga University of Medical Science, Setatsukinowa-cho, Otsu, Shiga, Japan
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