ABSTRACT

Bronchopleural fistula is a serious complication occurring after bronchial resections and may lead to mortality. In this study we aimed to investigate the effect of cyanoacrylate, a tissue adhesive, in bronchial closure methods. During this experimental study a total of 40 sheep lung and trachea were removed together. After left pneumonectomy in these cases, four groups with 10 cases in each were constituted. In Group I bronchial stump was closed with 4/0 Premilene® continuous horizontal matrix+over and over continuous sutures. Bronchial stapler was used in Group II. In Group III, bronchial stump was closed with the same technique used in Group I and cyanoacrylate was applied onto it. In Group IV, bronchial suturing was made using 4/0 Premilene® in a continuous horizontal suture and then cyanoacrylate was applied onto it. Cases were intubated with an endotracheal tube which was already connected to a sphygmomanometer. The cases were sank into the water, and the leakage test from the bronchial opening was performed with the pressure provided by the cuff. The median leakage pressure (300 mmHg) in Group III was statistically significantly higher (p<0.01). There were no statistically significant differences among the mean leakage pressures of the other methods (p>0.05). Cyanoacrylate, a tissue adhesive was successful in preventing bronchial leakages in high pressures. We suggest that cyanoacrylate may be used as an efficient method in the closure of bronchial stumps after pneumonectomy with more detailed studies and further techniques that will be developed

Keywords: Bronchial fistula, cyanoacrylate, stapler