Preventive esophagomyobronchoplasty as a method to prevent the failure of the bronchial stump in pneumonectomy for lung cancer

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Abstract

Aim. Comparative analysis of insufficiency rate of bronchial stump sutures in pneumonectomy for lung cancer, depending on suturing techniques.

Methods. A patented technique for bronchial stump suturing has been introduced into the practice of the GOBUZ clinic “Novgorod Regional Clinical Hospital” based on the Department of thoracic surgery since 2015 for pneumonectomy for lung cancer. Before the introduction of the developed technique, various generally accepted methods of bronchial stump forming were used (mechanical suture, manual suture, their combination, bronchial stump coverage with mediastinal pleura, pericardial flap). A retrospective analysis of 173 case histories and operational protocols of patients with lung cancer who underwent pneumonectomy was carried out for the failure of bronchial stump sutures when using conventional suturing techniques between 2010 and 2014 (the first group of patients). We also performed a retrospective and prospective analysis of 204 case histories and operational protocols of patients in a similar clinical group when using a patented suturing technique between 2015 and 2020 (the second group of patients). Statistical analysis was carried out by using Statistica 10.0 software (StatSoft, Inc. 2011). The qualitative and quantitative indicators were analyzed by using the Pearson’s χ2-test with Yates’s correction.

Results. A retrospective analysis shows that the failure rate in the use of generally accepted bronchial stump suturing techniques for 2010–2014 was 10.4%. After the implementation of the method of preventive esophagobronchomyoplasty, complications as bronchial stump suture failure were not detected in any case between 2015 and 2020.

Conclusion. The study shows high efficiency, a decrease in the incidence of complications as the failure of bronchial stump sutures in the use of the developed method of preventive esophagomyobronchoplasty in pneumonectomy for lung cancer.

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About the authors

R A Sulimanov

Yaroslav-the-Wise Novgorod State University

Author for correspondence.
Email: sulimanov@mail.ru
Russian Federation, Veliky Novgorod, Russia

R R Sulimanov

Yaroslav-the-Wise Novgorod State University

Email: sulimanov@mail.ru
Russian Federation, Veliky Novgorod, Russia

E S Spassky

Yaroslav-the-Wise Novgorod State University

Email: sulimanov@mail.ru
Russian Federation, Veliky Novgorod, Russia

T V Fedorova

Yaroslav-the-Wise Novgorod State University

Email: sulimanov@mail.ru
Russian Federation, Veliky Novgorod, Russia

M A Kholodova

Yaroslav-the-Wise Novgorod State University

Email: sulimanov@mail.ru
Russian Federation, Veliky Novgorod, Russia

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Supplementary files

Supplementary Files
Action
1. Рис. 1. Способ предупреждения несостоятельности швов культи бронха: а — культя бронха (1), уровень пищевода для пластики (2); б — мышечная стенка пищевода (1), хрящевая часть бронха (2), мембранозная часть бронха (3); в — наложенные узловые швы с «подхватыванием» стенки пищевода и закрытием культи главного бронха в виде «капюшона» (1)

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