STUDY OF ENDOSCOPIC STAPLE FORMATION BY SPECIMEN RADIOGRAPHY ON PULMONARY WEDGES

The advent in video-assisted thoracic surgery has rendered us to rely more and more on mechanical devices, We prospectively studied staple f ormation on resected lung specimen by radiography and attempted to cor relate this with the clinical outcome, From February 1994 to January 1 995, 36 consecutive pulmonary wedges (23 apical bullae, 12 pulmonary m etastases, 1 tuberculoma) from 31 patients who had undergone resection by endoscopic staple-cutter (Endo GIA30, USSC) were examined by two-p lane radiography for staple alignment and closure, Imperfect staple fo rmation was found in 21 (58%) of resected specimens, The median size o f the resected bullae is 4.2 mL (range, 2.0 to 58.8 mL) compared with 36 mL (range, 1.2 to 222.8 mt) in the resected metastases and tubercul oma specimen, Despite detecting more imperfect staples in the metastas es group (77% vs 57%), there was little difference in the two groups w ith respect to postoperative chest drainage duration (median, 3 vs 2 d ays) or hospital stay (median, 2 vs 2 days), We conclude that the curr ently available endoscopic staplers are by no means perfect, especiall y for resection of larger specimens, even though this may not be appar ent clinically, A continuous search for improvement in endoscopic stap lers designed specifically for lung resection is needed.