Bronchopleural fistula following pneumonectomy for carcinoma of the bronchus: mechanical stapling versus hand suturing.

Four hundred fifty cases of pneumonectomy for carcinoma of the bronchus are reviewed. The incidence of bronchopleural fistula is compared in two separate groups differentiated according to whether the bronchus was closed with interrupted sutures or with the auto-suture stapling clamp. The incidence of fistula was 11.1% in the interrupted suture group and 2.6% with the auto-suture group. The diagnosis and the method of treatment in this unit are discussed and the etiologic factors responsible for the fistula are reviewed. The conclusions are that there is no single causative factor in the development of bronchopleural fistulas and that the incidence of fistula is considerably reduced by the use of the auto-suture clamp.