Le suturatrici in chirurgia polmonare

Surgical materials have enormously improved in recent years and stapling devices have been widely introduced. Their use both eased surgical procedures and increased sutures safety, thus reducing suture leakage and related complications. The Authors examine 134 pulmonary neoplams treated at the Department of Surgery of the University di Perugia between May 1, 1986 and December 31, 1989, represented by different ages and tumor extension patients. Staplers have been widely used in those patients; particularly bronchial suture was always performed using a linear stapler. In a certain number of cases presenting intricating scissure, the scissure reopening was performed with linear stapler model G.I.A. or T.A. G.I.A. has been preferred wherever possible because its use helps to maintain the operative field free from blood and bronchial secretions. During the last year we also employed in 35 cases vascular mechanical staplers both for pulmonary artery and veins sutures; in our experience their use allows an easy performance of the vascular suture even in difficult positions, and with higher precision than with manual sutures, the only disadvantage being represented by high cost. Reduced number of air leakage and shorter operative phases, most important in critical patients, are other advantages related to the use of mechanical devices. We noticed a lower rate of major complications when using staplers than with manual sutures, consisting in two bronchial fistulas; no hemorrhage and reduced infective complications and air leakage were observed. According to our experience we believe the use of mechanical staplers in thoracic surgery will increase, even for vascular stumps, due to the possibility of suturing in difficult technical situation and reduction of complications related to their use