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Comparison of Two Different Suturing (Closing) Techniques After Partial Lung Lobectomy on Ovine Model – Ex Vivo Study

Lung lobectomy is used to remove lung tumours, congenital lung anomalies, chronic lung collapse, post-traumatic diffuse parenchymal laceration and bronchial rupture. A total of 12 lungs, taken from sheep cadavers, were used. The lungs were intubated with a cuffed tube and the tube was connected to an anaesthesia machine. The lungs were left on the same settings for 5 min before the lobectomy. The respiratory rate was 20/min, the inspiratory pressure (IP) was 20 cm H2 O and the air flow was set on 1 L/min. After 5 min, IP was decreased to 10 cm H2 O and the respiratory rate to 10/min. The right cranial lobe was partially removed from all samples. The pulmonary samples were divided into two groups, depending on which lobectomy technique was used. In the first 6 samples, the incision line was closed with overlapping and simple continuous suture in two layers. In the second 6 samples, the incision line was closed by using a blood vessel sealing device. After the lobectomy, the respiratory rate was raised to 20/min and IP was increased by 2 cm H2 O every 5 breathes. The lungs were submerged in the water for an easier assessment of the incision line failure. IP was increased until it reached the maximum value of 60 cm H2 0. The chi- squared test was used to determine whether there was a significant difference between the numbers of pulmonary samples that exceeded IP of 20 cm H2 O in the two groups. In the first group, 6/6 reached a value higher than 20 cm H2 0 (4/6 reached the value of 60 cm H2 O). In the second group, in which blood vessel sealing was used, bubbles started to appear from the sealed incision site in 2/6, and in 4/6 bubbles started to appear from sites not connected to the lobectomy. The mean value in the second group was 33.5 cm H2 O and 5/6 lunges reached a value higher than 20 cm H2 O. The difference among the two groups related to the number of lungs samples that exceeded IP of 20 cm H2 O was not observed (p > 0.05). In this study, it has been shown that both methods are suitable options for a lobectomy since the optimum value of IP in live animals in anaesthesia should not exceed 20 cm H2 O.

lung, suture, lobectomy, sheep

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