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Ann Thorac Surg 1975;19:242-247
© 1975 The Society of Thoracic Surgeons


Articles

Pneumonectomy by "En Masse" Stapling of Hilar Vessels

Ronald J. Gaskin, M.D., Martin Bergmann, M.D.*

Department of Surgery, The Jewish Hospital of St. Louis, and Washington University School of Medicine, St. Louis, Mo

* Address reprint requests to Dr. Bergmann, 8515 Delmar, Suite 220, St. Louis, Mo. 63124

Since the development of automatic surgical stapling instruments in the Soviet Union in the 1950s and their description in the American literature in 1961, American surgeons have used them for a variety of pulmonary resections. However, there is no account of their use in this country for pneumonectomy by "en masse" stapling of the hilar structures. We have used this whenever it was applicable in 41 consecutive pneumonectomies since 1967. There were 2 postoperative deaths, 1 due to pulmonary embolism and the other to myocardial infarction. There were no complications attributable to the operative technique used. The only empyema developed nine months postoperatively and was not accompanied by bronchial fistula. Cancer-free survival was 43% at two and one-half years and 33% at five years. The technique of en masse stapling of hilar vessels renders pneumonectomy easier, safer, and faster than the usual technique of individual ligation.




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