Bronchial stump closure with amniotic membrane in animal model

Gholamreza Mohajeri, Mohammad Omid, Hamid Melali, Mitra Heydarpour, Amir Hosein Davarpanah Jazi


Background: Coverage of the bronchial stumps (BSs) with adjacent tissues can improve healing and reduce bronchial complications in complex thoracic surgery. There is no evidence for the application of human amnion allograft for prevention of air leak from the BS. The comparison of the amniotic membrane (AM) and pleural patch for BS healing after lobectomy in dogs was our aim in this study. Materials and Methods: A total of eight males and females 12-24-month-old dogs between 17 and 22 kg body-weight were used in this study in 2010, Isfahan University of Medical Sciences. Animals were separated into two groups: group A (n = 4; amniotic membrane) and group P (n = 4; pleural patch) according to the BS closure technique performed. After lobectomy of the right middle lobe, the BS was closed, while a small bronchopleural fistula (BPF) was created by inserting a catheter via edges of closed stump. Then, it was covered with a piece of AM3 × 3 cm in group A and with a pedicle graft of pleura in group P.Rethoracotomy was performed after 15 days of observation, and the BS was removed for histological examination. Histological healing was classified as complete or
incomplete healing. Neoangiogenesis was measured by Von Willebrand expression using immunohistochemistry (IHC). Data were analyzed by SPSS version 15 using Fisher’s exact test, Mann-Whitney test, and T tests. Results: BPF complications were not seen during observation period. There was no significant difference in histological healing between two groups. Similarly, no significant difference was observed between the groups in terms of neoangiogenesis based on IHC examination (P value = 0.69). Conclusion:Human amnion allograft could be as effective as pleural patch for BS wrapping following pulmonary resections.

Key words: Amniotic membrane, bronchial stump, bronchopleural fistula, pneumonectomy

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