Bronchopleural fistula after closure of bronchus with staples or sutures

Abstract

The incidence of bronchopleural fistula after stapling and suturing in 832 pulmonary resec-tions was reveiwed. There were 8 fistulas in 332 stapled cases (lobectomy, 3 ; bilobectomy, 3 ; pneumonectomy, 1.). We found that leg length 3.5 mm staples were sometimes too tight to close a lobar bronchus. Use of the proper size of staple is extremely important to avoid the complication of bronchopleural fistula. The stapler should not to be used when the bronchus is inflamed or thickened. There were 6 fistulas in 500 sutured cases (lobectomy, 2 ; bilobectomy, 2 ; pneumonectomy, 2), 5 of them in 294 sutured with Sweet's method and only 1 in 206 sutured with Overholt's. We think that the latter method is best for bronchus closure if the surgeon is skillful enough to perform good suturing.