Influence of Short-term Steroid Therapy on Bronchial Anastomosis

Suture granulation is one of the postoperative complications following bronchoplastic procedures. To assess the preventive effect of suppressing suture granulation with short-term use of corticosteroid, left upper sleeve lobectomy was performed on 42 dogs. Prednisolone (2mg/kg) was used in 19 dogs from the operation day for 7 days. Postoperative serial bronchoscopies were performed at intervals. The animaln were sacrificed at 4, 7, 14 and 28 day postoperatively and bronchial breaking strength measurement and postmortem bronchial angiography were carried out. Contraction index of anastomotic line was evaluated in 10 dogs at 28 days. Endoscopically, the steroid-treated animals showed lesser inflammatory changes and low incidence of stenosis at the bronchial anastomosis. Slight decrease of bronchial breaking strength in the steroid-treated group was recognized at 7,14 days postoperatively, but was not significantly different from their untreated counterparts. Is the steroid-treated dogs, restoration of bronchial circulation at the anastomosis was delayed only in the early postoperative period and contraction at the anastomotic line occurred in a lesser tendency than the controls in the late healing phase. These results suggest that short-term administration of corticosteroid decreases inflammation and excessive granulation at anastomotic site and only has a little inhibition on the early phase of bronchial healing