31. A COMPARATIVE STUDY OF BUTTRESSED VS NON-BUTTRESSED STAPLE LINE IN PULMONARY RESECTIONS
Joseph I. Miller*, Rodney J. Landreneau*, Carolyn E. Wright, Tibetha S. Santucci, Bonnie H. Sammons
The Emory Clinic
Atlanta, Georgia, USA
BACKGROUND
A prolonged air leak is the major limiting factor in early hospital discharge after pulmonary resection. The purpose of this study was to determine if the use of bovine pericardial strips as a buttress along the lung staple line would decrease air leaks, hospital stay, and postoperative morbidity after lobectomy and segmentectomy.
MATERIAL AND METHODS
This was a multicenter trial consisting of 70 patients undergoing pulmonary resection, randomly assigned to the control group or treatment group. The control group (n=36) had staples only used in the pulmonary resection while the treatment group had the staple line buttressed with bovine pericardial strips (n=34).
RESULTS
The sample consisted of 43 males and 27 females, mean age of 64.5 years, 55 who underwent lobectomy and 15 who had a segmentectomy. No significant differences were noted between groups regarding demographic characteristics, preoperative laboratory values, or pulmonary function tests. No group differences were noted in the postoperative laboratory values, arterial blood gases, or transfusion rates. No statistical differences were noted in the mean ICU length of stay (P = 0.9), air leak duration (P = 0.17), number of days with a chest tube (P = 0.7), or total length of stay (P = 0.31).
Two deaths occurred in the control group and none in the treatment group. Increased air leak duration was associated with both assignment to the control group (r = 0.20, P = 0.05) and mortality (r = 0.25, P = 0.03). The mean duration of air leak was 2 days and the mean time to chest tube removal was 5 days in patients with a buttressed staple line compared to 3 days and 6 days respectively for patients with non-buttressed staple lines.
CONCLUSION
Patients who had the bovine pericardial strips used had a clinically significant shorter air leak duration and hospitalization. From this study, it would appear that the cost of bovine pericardium justifies its use by decreasing duration of air leak, time to chest tube removal, and hospital stay.
