Evaluation of a knotless barbed suture for canine total lung lobectomy: An ex vivo study.

Abstract

Objective: To compare leakage pressure and ligation time of bronchial sealing using barbed sutures, stapling devices, or traditional sutures during total lung lobectomy in dogs.

Study design: Experimental ex vivo study with randomized order of procedures.

Sample population: A total of 30 lung lobes from five canine cadavers weighing 10-13 kg.

Methods: The lobe samples were randomly allocated to the stapling device (ST), traditional suture ligation (TR), or barbed suture ligation (BA) group (n = 10 each). Bronchial ligation time was recorded for each procedure. Each bronchial stump was tested for air leakage for pressures up to 80 cmH₂O.

Results: The median air leakage pressure was 45.0 cmH₂O (range: 30.0-80.0) for the ST, 47.5 cmH₂O (range: 36.0-80.0) for the TR, and 57.5 cmH₂O (range: 25.0-80.0) for the BA (p = .36). No group showed leakage at physiological airway pressures (< 20 cmH₂O). At pressures up to 80 cmH₂O, leakage was observed in nine of 10 bronchial stumps in the ST, eight of 10 in the TR, and six of 10 in the BA (p = .43). The mean bronchial ligation time was 2.4 ± 0.5 min for the ST, 14.1 ± 3.4 min for the TR and 10.7 ± 1.6 min for the BA (p < .01).

Conclusion: Barbed sutures for bronchial closure provided comparable leakage pressure to stapling devices and traditional sutures and reduced suturing time compared to traditional sutures.

Clinical significance: Barbed suture ligation might be a viable alternative for canine total lung lobectomy.