The Use of Heterologous Bovine Pericardium in the Closure of Bronchial Stump After Lung Resections, Experimental Study

Bud V¹, Suciu B¹, Copotoiu Ruxandra², Sin Anca³, Cotoi O3, Butiurcă V⁴, Cordos B⁵, Brânzaniuc Klara⁶, Copotoiu C¹

1 1st Surgical Clinic, County Emergency Clinical Hospital, Tîrgu Mureș, Romania
2 ICU, County Emergency Clinical Hospital, Tîrgu Mureș, Romania
3 Department of Anatomopathology, County Emergency Clinical Hospital, Tîrgu Mureș, Romania
4 Student, University of Medicine and Pharmacy, Tîrgu Mureș, Romania
5 Veterinarian, University of Medicine and Pharmacy, Tîrgu Mureș, Romania
6 Department of Anatomy, University of Medicine and Pharmacy, Tîrgu Mureș, Romania

Introduction: There are many authors who have devoted their time and expertise to find creative ways for an ideal suture of bronchial stump. Despite their efforts, the bronchial fistula rate reported in the specialty literature remains high, between 2–16%, depending on the author. There are two methods for closing bronchial stumps: manual and mechanical suture. The aim of this study was to experiment a new technique for closing bronchial stumps after lung resections.
Material and method: In order to carry out this study we used 15 common rabbits. We performed left inferior lobectomy in these rabbits. These rabbits were divided into three groups according to the methods used to close the bronchial stump. We used three methods for closing the bronchial stump: simple running suture, suture of the bronchial stump using two vicryl mesh patches and suture of the bronchial stump using two heterologous bovine pericardial patches.
Results: We did not notice any cases of bronchial stump fistula. The most important changes that appear during the bronchial stump healing are: inflammatory response, angiogenesis, hyperplasia of the smooth muscle fibres, migration of fibroblasts and fibrogenesis.
Conclusions: Healing signs appeared on all examined samples, but they were more intensive in the group where we used the heterologous bovine pericardium for closing the bronchial stump. Some further studies are necessary to examine the effectiveness of the use of heterologous bovine pericardium to protect the bronho-anastomosis.