A study of the bronchial stump closure techniques following lobectomy or segmentectomy for primary lung cancer : The usefulness of the simple ligation method

We investigated the bronchial stump closure techniques following lobectomy or segmentectomy for primary lung cancer. Previously, the autosuture devices (stapler) were used in our institution. From 1999, we applied the simple ligation method. We studied the usefulness of the simple ligation method compared with the autosuture method. In the "Autosuture device group" (519 cases), postoperative bronchopleural fistulas occurred in 5 cases (1.0%). In the other hand, there was no complication in the "Simple ligation group" (253 cases). In the cases of bronchopleural fistulas in the "Autosuture device group", it was suggested endoscopically that the complication was caused by the mismatch between the stapler and the bronchus. The merits of the simple ligation method are 1) it is a safe and simple procedure at VATS surgery, 2) it is cost effective, 3) equivalent pressure is applied around the bronchial stump, so there is less deformity, 4) since sutures are not exposed in the bronchial stump cavity, infections are less likely to occur. The results of the present study showed that the simple ligation method for lobectomy or segmentectomy is available.