Are sutures better than staples for closing bronchi and pulmonary vessels?

Abstract

Little is known about the strength of suture lines and stapled closures of the bronchus, pulmonary arteries, and pulmonary veins. This experiment tested and compared the hydrostatic leakage point of each of these structures when closed by either sutures or staples. Fourteen fresh mature porcine cadavers and 8 human cadavers of age greater than 50 years were studied to determine whether the pig could be used as an appropriate model for future in vivo studies. Cadavers were selected so that closures depended only on the material used and not on any clot reinforcing the closure lines. The results of the study suggest that staple closure of the pulmonary artery and the main bronchus is as secure as suture closure. Pulmonary veins leak at a lower pressure when closed with staples; however, this pressure far exceeds physiological pressures in the left atrium. The data also suggest that the pig is an appropriate model for approximating conditions found in patients and is a good model for chronic studies comparing suture and staple closures.