Pericardium matrix buttressing hinders the stapled bronchial stump healing

Vannucci, Jacopo; Gervasi, Gian Luca; Freddolini, Marco; Pistilli, Alessandra; Monte, Valentina De; Bufalari, Antonello; Rende, Mario; Puma, Francesco

doi:10.1016/j.jss.2015.11.013

Cited by 4 publications

(4 citation statements)

References 24 publications

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“…At present, the proportion of suture staples in surgery has increased year by year, especially in the application of endoscopic surgery [ 54 ]. In addition to the gastrointestinal tract, suture staples can also be widely applied for pulmonary anastomosis [ 55 ], bronchial anastomosis [ 56 , 57 ], and esophagogastric anastomosis [ 58 ]. Therefore, more exploration works of biodegradable staples are still needed in the future.…”

Section: Discussionmentioning

confidence: 99%

A biodegradable magnesium surgical staple for colonic anastomosis: In vitro and in vivo evaluation

Zhang

Cao

et al. 2023

Bioactive Materials

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Section: Discussionmentioning

confidence: 99%

A biodegradable magnesium surgical staple for colonic anastomosis: In vitro and in vivo evaluation

Zhang

Cao

et al. 2023

Bioactive Materials

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“…Each pig was approached in right lateral decubitus and the left lung was removed through thoracotomy. The whole procedure and the perioperative management were performed according to the previously described technique [ 87 , 88 ]. After surgery, pigs were observed for 60 days, then they were painlessly sacrificed under general anaesthesia and the right lung was harvested.…”

Section: Methodsmentioning

confidence: 99%

Genome-wide expression of the residual lung reacting to experimental Pneumonectomy

Napolioni

Bianconi²,

Potenza

et al. 2021

BMC Genomics

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Background Acute or chronic irreversible respiratory failure may occur in patients undergoing pneumonectomy. Aim of this study was to determine transcriptome expression changes after experimental pneumonectomy in swine model. Experimental left pneumonectomy was performed in five pigs under general anaesthesia. Both the resected and the remaining lung, after 60 post-operative completely uneventful days, underwent genome-wide bulk RNA-Sequencing (RNA-Seq). Results Histological analysis showed dilation of air spaces and rupture of interalveolar septa. In addition, mild inflammation, no fibrosis, radial stretch of the bronchus, strong enlargement of airspaces and thinning of the blood supply were observed. Bioinformatic analyses of bulk RNA-Seq data identified 553 Differentially Expressed Genes (DEGs) at adjusted P-value below 0.001, between pre- and post-pneumonectomy. The top 10 up-regulated DEGs were Edn1, Areg, Havcr2, Gadd45g, Depp1, Cldn4, Atf3, Myc, Gadd45b, Socs3; the top 10 down-regulated DEGs were Obscn, Cdkn2b, ENSSSCG00000015738, Prrt2, Amer1, Flrt3, Efnb2, Tox3, Znf793, Znf365. Leveraging digital cytometry tools, no difference in cellular abundance was found between the two experimental groups, while the analysis of cell type-specific gene expression patterns highlighted a striking predominance of macrophage-specific genes among the DEGs. DAVID-based gene ontology analysis showed a significant enrichment of “Extrinsic apoptotic signaling pathway” (FDR q = 7.60 × 10− 3) and “Response to insulin” (FDR q = 7.60 × 10− 3) genes, along with an enrichment of genes involved as “Negative regulators of DDX58/IFIH1 signaling” (FDR q = 7.50 × 10− 4) found by querying the REACTOME pathway database. Gene network analyses indicated a general dysregulation of gene inter-connections. Conclusion This translational genomics study highlighted the existence both of individual genes, mostly dysregulated in certain cellular populations (e.g., macrophages), and gene-networks involved in pulmonary reaction after left pneumonectomy. Their involvement in lung homeostasis is largely supported by previous studies, carried out both in humans and in other animal models (under homeostatic or disease-related conditions), that adopted candidate-gene approaches. Overall, the present findings represent a preliminary assessment for future, more focused, studies on compensatory lung adaptation, pulmonary regeneration and functional reload.

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“…Prolonged air leakage (PAL) is a common complication following pneumonectomy, with an incidence rate of approximately 15% ( Downey et al, 2006 ). Several studies have demonstrated that PAL can increase the duration of chest tube use ( Vannucci et al, 2016 ), length of hospital stay ( Safranek et al, 2005 ), medical costs ( Nishida et al, 2017 ), and risk of infectious complications, such as pneumothorax and pneumonia ( Murakami et al, 2018 ). To address this issue, various staple line reinforcement patches have been developed, and a comparative analysis of these products is presented in Table 2 .…”

Section: Staple Line Reinforcement Patches Used For Surgerymentioning

confidence: 99%

“…At 95 and 167 days postoperatively, the inflammation gradually declined in the BP groups, but the amount of tissue coverage remained low and BP was not absorbed by the surrounding tissues, while the thickness of newly formed tissues significantly increased in the ePTFE groups. In addition, research has shown that BP may prolong the healing process of broken ends of the staple line and cause an obvious inflammation response at 60 days postoperatively, with large amounts of granulation tissues presented in the operative locations ( Vannucci et al, 2016 ). Kevin D. Murray et al reinforced human cadaveric lung tissue using ePTFE and BP and then tested the pressure resistance ( Murray et al, 2002 ).…”

Section: Staple Line Reinforcement Patches Used For Surgerymentioning

confidence: 99%

The clinical effectiveness of staple line reinforcement with different matrix used in surgery

Wei

Huang

Jiang

et al. 2023

Front. Bioeng. Biotechnol.

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Staplers are widely used in clinics; however, complications such as bleeding and leakage remain a challenge for surgeons. To tackle this issue, buttress materials are recommended to reinforce the staple line. This Review provides a systematic summary of the characteristics and applications of the buttress materials. First, the physical and chemical properties of synthetic polymer materials and extracellular matrix used for the buttress materials are introduced, as well as their pros and cons in clinical applications. Second, we review the clinical effects of reinforcement mesh in pneumonectomy, sleeve gastrectomy, pancreatectomy, and colorectal resection. Based on the analysis of numerous research data, we believe that buttress materials play a crucial role in increasing staple line strength and reducing the probability of complications, such as bleeding and leakage. However, considering the requirements of bioactivity, degradability, and biosafety, non-crosslinked small intestinal submucosa (SIS) matrix material is the preferred candidate. It has high research and application value, but further studies are required to confirm this. The aim of this Review is to provide comprehensive guidance on the selection of materials for staple line reinforcement.

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Pericardium matrix buttressing hinders the stapled bronchial stump healing

Cited by 4 publications

References 24 publications

A biodegradable magnesium surgical staple for colonic anastomosis: In vitro and in vivo evaluation

A biodegradable magnesium surgical staple for colonic anastomosis: In vitro and in vivo evaluation

Genome-wide expression of the residual lung reacting to experimental Pneumonectomy

The clinical effectiveness of staple line reinforcement with different matrix used in surgery

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