Comparative Study Of Bronchopleural Fistula With Different Methods Of Closing Bronchi In The Operation Of The Lung Cancer

Objective:In pulmonary resections of lung cancer, the techniques of simple ligation,suture ligation(superficial suture ligation+remote continuous suture),simple full-thickness interrupted suture (Sweet Method,simple mechanical stapling,and mechanical stapling with Sweet Method or the coverage of the surrounding living tissue to strengthen are applied to enhance treatment of bronchial stump. Comparative analysis of their closed effects,which is accordingly evaluated different closure techniques of bronchial stump in clinical application value, are looking forward to avoid or reduce the incidence of postoperative bronchopleural fistula, enhancing the effect of surgical treatment.Methods:Retrospective analysis of the pulmonary resection of lung cancer come from the patient of our hospital, which is applied the different treatment of 1888 cases of bronchial stump from July 2002 to December 2009. According to the different treatment of bronchial stump were divided into five groups:A group with simple ligation includes 348 cases, accounting for 18.43%; B group with ligation suture is 295 cases, accounting for 15.63%; C group is Simple full-thickness interrupted suture with 302 cases, accounting for 16.00%; D group is Simple mechanical stapling with 423 cases, accounting for 22.40%; E group is mechanical stapling with Sweet Method or the coverage of the surrounding living tissue to strengthen with 520 cases, accounting for 27.54%.The BPF incidence of A, B, C, D and E applications X2 test, while between groups were compared by SPSS16.0 Software. Results:In the different treatment of 1888 cases of bronchial stump, there were 44 cases of bronchopleural fistula(overall incidence rate is 2.33%).A group including bronchopleural fistula was 13 cases (3.74%); B group including bronchopleural fistula was 1 case (0.34%); C group including bronchopleural fistula occurred was 13 cases (4.3%); D group including bronchopleural fistula was 15 cases (3.55%); E group including bronchopleural fistula was 2 cases (3.85%). There is significant difference in the BPF incidence of A, B, C, D and E, which calculates X2= 24.73; P=0.000. P<0.05, comparative analyses of between groups come that X2 and P of A group and B group,A group and C group,A group and D group,A group and E group,B group and C group,B group and D group,B group and E group,C group and D group,C group and E group,D group and E group areX2=8.648,0.003; X2=0.136, P=0.712; X2=0.020, P=0.889; X2=13.785, P=0.000; X2=10.248, P=0.001; X2=8.205, P-0.004; X2=0.011, P=0.918; X2=0.273, P=0.601; X2=16.387, P=0.000; X2=13.170, P=0.000. There are significant differences between A group and B group, A group and E group, B group and C group, B group and D group, C group and E group, D group and E group. There are not significant differences between A group and C group, A group and D group, B group and E group, C group and D group.Conclusion:Although using different technologies of the closure of bronchial stump, there are still operative failures. Its incidence is acceptable. There are basically the same in the BPF incidence of between suture ligation and mechanical stapling with Sweet Method or the coverage of the surrounding living tissue to strengthen; There are basically the same in the BPF incidence of simple ligation simple full-thickness interrupted suture and simple mechanical stapling; Suture ligation and mechanical stapling with Sweet Method or the coverage of the surrounding living tissue to strengthen is superior to simple ligation,simple full-thickness interrupted suture and simple mechanical stapling.