TY - JOUR AU - Shimizu, Nahoko AU - Tanaka, Yugo AU - Okamoto, Takeshi AU - Doi, Takefumi AU - Hokka, Daisuke AU - Maniwa, Yoshimasa PY - 2018 TI - How to prevent adverse events of vascular stapling in thoracic surgery: recommendations based on a clinical and experimental study JF - Journal of Thoracic Disease; Vol 10, No 12 (December 30, 2018): Journal of Thoracic Disease Y2 - 2018 KW - N2 - Background: Advances in the development of staplers for pulmonary vessels have contributed to safe and convenient procedures in thoracic surgery. However, adverse events (AEs) can occur during vascular stapling and cause fatal hemorrhage. We aimed to assess the risk level of using the vessel stapling procedure to reduce such AEs. Methods: First, an animal experiment using pig cardiopulmonary blocks was conducted. Pulmonary arteries were closed with staplers under stressful conditions such as lifting or twisting; vessel stump endurance was analyzed through different methods. Second, AEs associated with clinical stapler use for pulmonary vessels were retrospectively reviewed by studying clinical videos of 263 patients. Results: In the animal experiment, the pressure resistance was significantly lower in the twisted group than in the no strain group (no strain vs . lifting: P=0.2008, no strain vs. twisting: P=0.002, no strain vs . twisting and lifting: P Conclusions: The pulmonary vessel stapling causes stress due to twisting and lifting that decreased stump durability. Avoiding such stress when using stapler for vessels leads to a safer thoracic surgery. UR - https://jtd.amegroups.org/article/view/25356