A comparative study of buttressed versus nonbuttressed staple line in pulmonary resections

Background. Prolonged air leak is the major limiting factor in early hospit al discharge following pulmonary resection. The purpose of this study was t o determine whether the use of bovine pericardial strips as a buttress alon g the lung staple line would decrease air leaks and hospital stay after lob ectomy and segmentectomy. Methods. This was a multicenter trial consisting of 80 patients undergoing pulmonary resection, randomly assigned to the control group (40 patients) o r treatment group (40 patients). The treatment group had reinforcement with bovine pericardium. Results. No statistical differences were noted in the mean intensive care u nit length of stay (p = 0.9), number of days with a chest tube (p = 0.6), o r total length of stay (p = 0.24). Increased air leak duration was associat ed with assignment to the control group (r = 0.27, p = 0.02). The mean dura tion of air leak was 2 days and the mean time to chest tube removal was 5.9 days in patients with a buttressed staple line compared to 3 days and 6.3 days, respectively, for patients with nonbuttressed staple lines. Conclusions. Within the data of this study, no statistical differences were noted between buttressed and nonbuttressed patients. However, the trend to ward shortened air leak time and tube removal time was apparent in the butt ressed group. With greater number of patients studied, it is likely that th e cost of bovine pericardium would be justified by shorter air leak duratio n and hospitalization. (Ann Thorac Surg 2001;71:319-23) (C) 2001 by The Soc iety of Thoracic Surgeons.