Manual suture of vascular and bronchial stumps

OBJECTIVE: To experimentally compare two classic techniques described for manual suture of the bronchial stump. METHODS: We used organs of pigs, with isolated trachea and lungs, preserved by refrigeration. We dissected 30 bronchi, which were divided into three groups of ten bronchi each, of 3mm, 5mm, and 7mm, respectively. In each, we performed the suture with simple, separated, extramucosal stitches in five other bronchi, and the technique proposed by Ramirez and modified by Santos et al in the other five. Once the sutures were finished, the anastomoses were tested using compressed air ventilation, applying an endotracheal pressure of 20mmHg. RESULTS: the Ramirez Gama suture was more effective in the bronchi of 3, 5 and 7 mm, and there was no air leak even after subjecting them to a tracheal pressure of 20mmHg. The simple interrupted sutures were less effective, with extravasation in six of the 15 tested bronchi, especially in the angles of the sutures. These figures were not significant (p = 0.08). CONCLUSION: manual sutures of the bronchial stumps were more effective when the modified Ramirez Gama suture was used in the caliber bronchi arms when tested with increased endotracheal pressure.

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Preventive esophagomyobronchoplasty as a method to prevent the failure of the bronchial stump in pneumonectomy for lung cancer

Kazan medical journal ◽

10.17816/kmj2021-940 ◽

2021 ◽

Vol 102 (6) ◽

pp. 940-945

Author(s):

R A Sulimanov ◽

R R Sulimanov ◽

E S Spassky ◽

T V Fedorova ◽

M A Kholodova

Keyword(s):

Lung Cancer ◽

Retrospective Analysis ◽

High Efficiency ◽

Clinical Group ◽

Case Histories ◽

Bronchial Stump ◽

Manual Suture ◽

Mechanical Suture ◽

Suturing Techniques ◽

Suture Failure

Aim. Comparative analysis of insufficiency rate of bronchial stump sutures in pneumonectomy for lung cancer, depending on suturing techniques. Methods. A patented technique for bronchial stump suturing has been introduced into the practice of the GOBUZ clinic Novgorod Regional Clinical Hospital based on the Department of thoracic surgery since 2015 for pneumonectomy for lung cancer. Before the introduction of the developed technique, various generally accepted methods of bronchial stump forming were used (mechanical suture, manual suture, their combination, bronchial stump coverage with mediastinal pleura, pericardial flap). A retrospective analysis of 173 case histories and operational protocols of patients with lung cancer who underwent pneumonectomy was carried out for the failure of bronchial stump sutures when using conventional suturing techniques between 2010 and 2014 (the first group of patients). We also performed a retrospective and prospective analysis of 204 case histories and operational protocols of patients in a similar clinical group when using a patented suturing technique between 2015 and 2020 (the second group of patients). Statistical analysis was carried out by using Statistica 10.0 software (StatSoft, Inc. 2011). The qualitative and quantitative indicators were analyzed by using the Pearsons 2-test with Yatess correction. Results. A retrospective analysis shows that the failure rate in the use of generally accepted bronchial stump suturing techniques for 20102014 was 10.4%. After the implementation of the method of preventive esophagobronchomyoplasty, complications as bronchial stump suture failure were not detected in any case between 2015 and 2020. Conclusion. The study shows high efficiency, a decrease in the incidence of complications as the failure of bronchial stump sutures in the use of the developed method of preventive esophagomyobronchoplasty in pneumonectomy for lung cancer.

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Laparoscopic Treatment of Rectovaginal Fistula with Manual Suture

Journal of Minimally Invasive Gynecology ◽

10.1016/j.jmig.2012.08.690 ◽

2012 ◽

Vol 19 (6) ◽

pp. S106

Author(s):

M.P. Oliveira ◽

C.P. Crispi ◽

F.M. Oliveira ◽

P.S. Reis ◽

T.S. Raymundo ◽

...

Keyword(s):

Rectovaginal Fistula ◽

Laparoscopic Treatment ◽

Manual Suture

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Ileocecal Fistula Caused by Multiple Foreign Magnetic Bodies Ingestion

Case Reports in Surgery ◽

10.1155/2018/7291539 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3

Author(s):

Vittorio Cherchi ◽

Gian Luigi Adani ◽

Elda Righi ◽

Umberto Baccarani ◽

Giovanni Terrosu ◽

...

Keyword(s):

Emergency Department ◽

Abdominal Pain ◽

Foreign Body ◽

Clinical Condition ◽

Correct Diagnosis ◽

Intestinal Wall ◽

Accidental Ingestion ◽

The Us ◽

Manual Suture ◽

One Year

The incidence of accidental foreign body (FBs) ingestion is 100,000 cases/year in the US, with over than 80% of cases occurring in children below 5 years of age. Although a single FB may pass spontaneously and uneventfully through the digestive tract, the ingestion of multiple magnetics can cause serious morbidity due to proximate attraction through the intestinal wall. Morbidity and mortality depend on a prompt and correct diagnosis which is often difficult and delayed due to the patient's age and because the accidental ingestion may go unnoticed. We report our experience in the treatment of an 11-year-old child who presented to the emergency department with increasing abdominal pain, vomiting, diarrhea, and fever. Surgery evidenced an ileocecal fistula secondary to multiple magnetic FB ingestion with attraction by both sides of the intestinal wall. A 5-centimeter ileal resection was performed, and the cecal fistula was closed with a longitudinal manual suture. The child was discharged at postoperative day 8. After one year, the patient’s clinical condition was good.

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Manual Sutureless Cataract Surgery (MSCS) in Patients with Pseudo-Exfoliation

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v36i4.1097 ◽

2020 ◽

Vol 36 (4) ◽

Author(s):

Yasir Iqbal ◽

Qaim Ali Khan ◽

Sohail Zia ◽

Muhammad Usman Arshad Qureshi ◽

Masud-ul- Hassan

Keyword(s):

Cataract Surgery ◽

Previous History ◽

Case Series ◽

Retinal Disease ◽

Applanation Tonometry ◽

Anterior Lens Capsule ◽

History Of ◽

Manual Suture ◽

Intraocular Lens Decentration ◽

Closed Angle

Purpose: To document the complications of Manual suture-less cataract surgery in eyes with pseudo-exfoliation. Study Design: Interventional case series. Place and Duration of Study: Naseer memorial hospital, Dadyal, Azad Jammu Kashmir, from 4 July 2017 to 3 July 2019. Methods: One hundred and fifty patients with pseudo-exfoliation (PEX) and cataract were selected by convenient sampling. Patients with systemic diseases, history of trauma, intraocular pressure ≥15 mm Hg on Applanation tonometry and any other associated ocular disease for example retinal detachment or retinal disease, previous history of glaucoma or narrow/closed angle on Gonioscopy were excluded from the study. Dark brown cataracts were also excluded. Pseudo-exfoliation was diagnosed on slit lamp on the basis of presence of dandruff like material on the pupil and the anterior lens capsule. The patients underwent manual suture less cataract surgery under local anesthesia Intraoperative and post-operative complications were noted. first day postoperatively. The collected data and analyzed using statistical package for social sciences (SPSS) version 21 for analysis. Results: The study group consisted of 64% males and 36% females with mean age of 65 ± 15.32 years. The most common difficulty encountered was poor pupil dilatation in 37.3% cases followed by Zonular dehiscence in 7.3%. On the first post-operative day, the most common complication was intraocular lens decentration in 2.6% of the cases. Conclusion: Pupils of patients with pseudo-exfoliation dilate poorly and makes surgery difficult. With good pupillary dilatation, careful capsulorhexis and minimal stress on the zonules, MSCS can be safely performed in eyes with cataract and PEX. Key Words: Pseudo-exfoliation, Cataract, Pupil.

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COMPARATIVE ANALYSIS OF LATE RESULTS OF CERVICAL ESOPHAGOGASTRIC ANASTOMOSIS BY MANUAL AND MECHANICAL SUTURE IN PATIENTS SUBMITTED TO ESOPHAGEAL MUCOSECTOMY THROUGH ADVANCED MEGAESOPHAGUS

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/0102-672020190001e1462 ◽

2019 ◽

Vol 32 (4) ◽

Author(s):

José Luis Braga de AQUINO ◽

Vania Aparecida LEANDRO-MERHI ◽

José Alexandre MENDONÇA ◽

Elisa Donalisio Teixeira MENDES ◽

Conceição de Maria Aquino Vieira CLAIRET ◽

...

Keyword(s):

Late Results ◽

Esophagogastric Anastomosis ◽

Systemic Complications ◽

Early Evaluation ◽

Group A ◽

Manual Suture ◽

Cervical Esophagogastric Anastomosis ◽

Mechanical Suture ◽

Group B ◽

Clinical Conditions

ABSTRACT Background: Among the anastomoses of the gastrointestinal tract, those of the esophagus are of special interest due to several anatomical or even general peculiarities. Aim: Evaluate retrospectively the results comparing mechanical vs. manual suture at cervical esophagogastric anastomosis in megaesophagus treatment. Methods: Were included 92 patients diagnosed with advanced megaesophagus with clinical conditions to undergo the surgery. All underwent esophageal mucosectomy, performing anastomosis of the esophagus stump with the gastric tube at the cervical level. In order to make this anastomosis, the patients were divided into two groups: group A (n=53) with circular mechanical suture, lateral end; group B (n=39) with manual suture in two sides, lateral end. In the postoperative period, an early evaluation was performed, analyzing local and systemic complications and late (average 5.6 y) analyzing deglutition. Results: Early evaluation: a) dehiscence of esophagogastric anastomosis n=5 (9.4%) in group A vs. n=9 (23.0%) in group B (p=0.0418); b) stenosis of esophagogastric anastomosis n=8 (15.1%) in group A vs. n=15 (38.4%) in group B (p=0.0105.); c) pulmonary infection n=5 (9.4%) in group A vs. n=3 (7.6%) in group B (p=1.0000.); d) pleural effusion n=5 (9.4%) in group A vs. n=6 (15.4%) in group B (p<0.518). Late evaluation showed that 86.4-96% of the patients presented the criteria 4 and 5 from SAEED, expressing effective swallowing mechanisms without showing significant differences among the groups. Conclusion: Cervical esophagogastric anastomosis by means of mechanical suture is more proper than the manual with lower incidence of local complications and, in the long-term evaluation, regular deglutition was acquired in both suture techniques in equal quality.

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