Bronchial anastomoses after lung transplantation: results with single running suture technique

Background: The standards technique for the bronchial anastomosis in LTX is a running suture on the membranous and single stitches on the cartilaginou s portion of the bronchus. The aim of this retrospective study was to compa re the results of this technique to the new single running suture technique . Methods: Between January and December 1998, 56 consecutive single (n = 17 ) and bilateral (n = 39) lung transplants in 52 patients were performed. Ei ghty-three bronchial anastomoses were retrospectively analyzed and evaluate d by separating into two groups: group 1 (24 patients, 39 anastomoses) with standard technique and group 2 (24 patients, 44 anastomoses) with single r unning suture. The two groups were comparable with regard to age, primary d iagnosis, intraoperative use of extracorporeal circulation, ischemia time, duration of mechanical ventilation, ICU and number of acute rejections/100 days. Bronchial healing was assessed with bronchoscopic follow-up (5-16 mon ths). Results: Primary excellent airway healing was observed in 36 anastomo ses (92%) in group I and in 41 (93%) in group 2. In 2 anastomoses in group 1 (5%) and in 2 anastomoses in group 2 (4.6%) necrosis less than 5 nun was observed. In one anastomosis in group 1 (2.7%) a 10-mm bronchial necrosis w ith partial occlusion of the bronchial lumen by necrotic tissue necessitate d temporary intraluminal stenting. In one anastomosis in group 2 (2.3%) mal acia. of the bronchus intermedius occurred. Conclusion: The single running suture technique for bronchial anastomosis is a safe technique providing th e same results as the established technique and we advocate its. use for br onchial anastomosis.