PMID- 30746189
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220331
IS  - 2072-1439 (Print)
IS  - 2077-6624 (Electronic)
IS  - 2072-1439 (Linking)
VI  - 10
IP  - 12
DP  - 2018 Dec
TI  - How to prevent adverse events of vascular stapling in thoracic surgery: 
      recommendations based on a clinical and experimental study.
PG  - 6466-6471
LID - 10.21037/jtd.2018.11.14 [doi]
AB  - BACKGROUND: Advances in the development of staplers for pulmonary vessels have 
      contributed to safe and convenient procedures in thoracic surgery. However, 
      adverse events (AEs) can occur during vascular stapling and cause fatal 
      hemorrhage. We aimed to assess the risk level of using the vessel stapling 
      procedure to reduce such AEs. METHODS: First, an animal experiment using pig 
      cardiopulmonary blocks was conducted. Pulmonary arteries were closed with 
      staplers under stressful conditions such as lifting or twisting; vessel stump 
      endurance was analyzed through different methods. Second, AEs associated with 
      clinical stapler use for pulmonary vessels were retrospectively reviewed by 
      studying clinical videos of 263 patients. RESULTS: In the animal experiment, the 
      pressure resistance was significantly lower in the twisted group than in the no 
      strain group (no strain vs. lifting: P=0.2008, no strain vs. twisting: P=0.002, 
      no strain vs. twisting and lifting: P<0.0001). Regarding clinical stapler use, 
      754 staplers were used against the vessels. AEs occurred in 9 cases, and 7 cases 
      were suspected to be caused by vessel tension. CONCLUSIONS: The pulmonary vessel 
      stapling causes stress due to twisting and lifting that decreased stump 
      durability. Avoiding such stress when using stapler for vessels leads to a safer 
      thoracic surgery.
FAU - Shimizu, Nahoko
AU  - Shimizu N
AD  - Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, 
      Japan.
FAU - Tanaka, Yugo
AU  - Tanaka Y
AD  - Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, 
      Japan.
FAU - Okamoto, Takeshi
AU  - Okamoto T
AD  - Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, 
      Japan.
FAU - Doi, Takefumi
AU  - Doi T
AD  - Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, 
      Japan.
FAU - Hokka, Daisuke
AU  - Hokka D
AD  - Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, 
      Japan.
FAU - Maniwa, Yoshimasa
AU  - Maniwa Y
AD  - Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, 
      Japan.
LA  - eng
PT  - Journal Article
PL  - China
TA  - J Thorac Dis
JT  - Journal of thoracic disease
JID - 101533916
CIN - J Thorac Dis. 2019 May;11(Suppl 9):S1216-S1221. PMID: 31245090
CIN - J Thorac Dis. 2019 May;11(Suppl 9):S1245. PMID: 31245098
PMC - PMC6344720
OTO - NOTNLM
OT  - Mechanical stapler
OT  - pulmonary artery
OT  - thoracoscopy
COIS- Conflicts of Interest: The authors have no conflicts of interest to declare.
EDAT- 2019/02/13 06:00
MHDA- 2019/02/13 06:01
PMCR- 2018/12/01
CRDT- 2019/02/13 06:00
PHST- 2019/02/13 06:00 [entrez]
PHST- 2019/02/13 06:00 [pubmed]
PHST- 2019/02/13 06:01 [medline]
PHST- 2018/12/01 00:00 [pmc-release]
AID - jtd-10-12-6466 [pii]
AID - 10.21037/jtd.2018.11.14 [doi]
PST - ppublish
SO  - J Thorac Dis. 2018 Dec;10(12):6466-6471. doi: 10.21037/jtd.2018.11.14.