Effect of in vivo and in vitro ethanol on adrenergic and purinergic responses of the bisected rat vas deferens to low and high frequency pulses

1. This study investigates the effect of acute in vivo and in vitro ethanol administration on the contractions evoked electrically and by exogenous noradrenaline and alpha,beta-methylene-ATP in the rat bisected vas deferens. 2. In vivo ethanol treatment (3 g kg(-1), i.p.) significantly potentiated the early purinergic (phase I) and the delayed adrenergic (phase II) phases evoked by single-pulse stimulation of the epididymal portion of the rat vas deferens, leaving unaffected both phases in the prostatic portion. In vitro 50 mM ethanol significantly depressed phase I leaving unaffected phase II in both portions from untreated rats. In vitro ethanol significantly depressed phase I in the epididymal portion from in vivo ethanol treated animals and potentiated phase II in both portions. 3. In vivo ethanol treatment (3.0 g kg(-1), i.p.) selectively impaired the response to noradrenaline only in the prostatic portion of rat vas deferens while it was devoid of any action on alpha,beta-methylene-ATP contractions. Ethanol 50 mM in vitro was devoid of any action on the response to exogenous noradrenaline and alpha,beta-methylene-ATP in both tissues. 4. In vivo ethanol treatment slightly but significantly increased the phasic response in the epididymal portion to trains of stimuli (2-30 Hz). In vitro 50 mM ethanol was ineffective against the phasic and tonic contractions elicited by the tetanus in both portions. 5. It is concluded that ethanol treatment affects purinergic and adrenergic pathways of transmission possibly leading to a disruption of physiological contractions necessary to seminal emission.

Alcohol differentially affects noradrenergic and purinergic responses in the bisected rat vas deferens

This study investigates the effect of acute in vivo or in vitro ethanol administration on the adrenergic and purinergic responses in the epididymal and prostatic portion of rat vas deferens. Acute in vivo ethanol treatment (3.0 g/kg, i.p.) selectively impaired the response to noradrenaline in the prostatic portion of rat vas deferens, leaving unaffected the epididymal portion. In addition, the response evoked by the maximal concentration of alpha, beta-methylene-ATP was significantly depressed by acute in vivo ethanol treatment in both the epididymal and prostatic segments. Ethanol 50 mM in vitro was devoid of any action on the response to exogenous noradrenaline in both tissues. Ethanol in vitro left unaltered the response to alpha,beta-methylene-ATP in the epididymal portion, while potentiated the contractile response in the prostatic one. These results provide, for the first time, evidence that ethanol in vitro and in vivo differentially affects the noradrenergic and purinergic responses in the bisected vas deferens, suggesting that this substance may alter the male reproductive tract function.

Locally advanced rectal cancer: a multivariate analysis of outcome risk factors

BACKGROUND AND OBJECTIVES

Stages II and III rectal tumors are known as locally advanced rectal cancer (LARC) because they are characterized by a high incidence of local and distant relapses and a low probability of long-term survival. Adjuvant treatments have been advocated to ameliorate overall survival (OS), local recurrence-free survival (LRFS), and metastasis-free survival (MFS) without a univocal beneficial trend. The aim of this study was to identify the independent predictive factors of OS, LRFS, and MFS which could best select patients for adjuvant treatment of LARC.

METHODS

Of 153 rectal cancer cases seen consecutively from 1991 to 1998, we studied the main clinical and pathological parameters of 73 LARCs. Clinical and pathological variables were studied by univariate analysis, and independent predictive factors were identified by multivariate analysis.

RESULTS

Stages II and III rectal cancer have shown not statistically different rates of OS, LRFS, and MFS. Factors independently associated with increasing OS and MFS were low preoperative carcinoembryonic antigen level (CEA), low number of metastatic lymph nodes, low percentage of metastatic lymph nodes out of the total number of lymph nodes excised, and adjuvant treatment. Increased staging and distal resection margins < or =1 cm were shown to be independent detrimental risk factors regarding OS and MFS, respectively. Independent prognostic factors associated with a reduction in LRFS were advanced age, Hartman's resection, distal resection margins < or =1 cm, and fewer than 14 resected nodes.

CONCLUSIONS

Whereas stage I rectal cancer can be treated with a good probability of cure by surgery alone, avoiding adverse effects of adjuvant regimens, the outcome of LARC appears to be positively influenced by adjuvant therapies. In LARC, an accurate study of risk factors would be useful to identify which subset of patients could be favorably influenced by postoperative radiochemotherapy.

Differential effects of drugs interacting with autonomic transmitters on responses of rat vas deferens to field stimulation

1. Frequency-response curves (0.1-30 Hz) were obtained in the epididymal portion of rat vas deferens. At low frequencies (0.1-1 Hz), the parameters evaluated were the first twitch and the fourth twitch at each frequency. The responses to trains of stimuli at intermediate (2-5 Hz) and high (10-30 Hz) frequencies were biphasic consisting of phase I (the first rapid phase of tetanus) and of phase II (the secondary slowly developing one). 2. Prazosin inhibited the first and the fourth twitch but not when the frequency was < 1 Hz. Suramin inhibited the first twitch while substantially depressing the fourth one. The combination of prazosin and suramin almost completely abolished all the twitches evoked by a train of stimuli at low frequencies. Nifedipine left almost unaltered the first twitch while markedly depressing the fourth one, especially at relatively high frequency (1 Hz). Verapamil was devoid of any inhibitory action. Papaverine depressed the first twitch while only at the highest concentration used (1 x 10(-4) M) markedly inhibited the fourth one. Chloroethylclonidine (CEC) depressed the first twitch and increased the fourth. 3. When intermediate (2-5 Hz) and high (10-30 Hz) frequencies are considered, prazosin and suramin partially inhibited both phase I and phase II, while in combination they almost completely abolished both phases. Nifedipine and verapamil selectively suppressed phase II, leaving phase I unaffected. Papaverine completely abolished both phase I and phase II. CEC was able to completely abolish phase I but increased phase II. 4. These results suggest that the response to the first twitch of a train at low frequency is prevailingly noradrenergic, prazosin-sensitive, while when the twitches are close enough (i.e. at 1 Hz) a summation of stimuli takes place and a predominant purinergic component, both suramin- and nifedipine-sensitive, becomes evident. 5. At high frequencies, both phases are due to the concomitant release of noradrenaline and adenosine triphosphate (ATP). The noradrenergic component of phase I is nifedipine-insensitive and CEC-sensitive, resembling the pharmacological profile of the endogenously released noradrenaline by single pulse, while that of phase II, nifedipine-sensitive and CEC-insensitive, is similar to that produced by exogenously applied noradrenaline.

Hepatoid carcinoma of the stomach: is it still an unusual anatomo-clinical entity? Six cases-report

Hepatoid carcinoma of the stomach is a rare neoplasm (especially in western countries) characterized by high levels of serum alpha-fetoprotein (AFP), the presence of "hepatoid foci" inside the gastric tumor and poor prognosis, due to the earlier onset of liver metastases. We treated six patients for hepatoid carcinoma of the stomach between 1990 and 1997. The female to male ratio was 1:1, the average age was 71 (54-81) and the average AFP-level was 1160 ng/ml (603-1531). We performed 2 total gastrectomies, 2 subtotal gastrectomies and 2 gastro-jejunostomies (due to presence of liver metastases): in one case, the patient underwent a splenectomy as well. All the tumors showed the presence of "hepatoid foci" (the morphological feature is close to the hepatocellular carcinoma) and a positive immunoreactivity to AFP. The mean survival was 3 months: only one patient is still alive and disease-free (with a 52 months follow-up). After radical surgery, she underwent a chemotherapic treatment with cisplatin, epirubicin, 5-fluorouracil and l-leucovorin. We conclude that our series (the widest in Italy and one of most impressive in Europe) confirm the poor prognosis of this neoplasm, but we also want to underline that this tumor is not so "unusual" any more and it requires new types of treatment, like postoperative chemotherapy, besides surgery, to be fighted properly.

Differential blockade of alpha,beta-methylene-ATP, noradrenaline and electrically evoked contractions of the rat vas deferens

The present study was carried out compare the effects of nifedipine, verapamil, papaverine and chloroethylclonidine (CEC) on the electrically-induced contractions and on the contractions produced by exogenous noradrenaline and alpha, beta methylene-ATP in the epidydimal portion of rat vas deferens. Nifedipine inhibited in a concentration-dependent fashion the purinergic component (phase I) of the electrically evoked response. Verapamil (10(-7) M-10(-5) M) did not inhibit significantly or even potentiated phase I of the contractile response to single-pulse field stimulation but inhibited the response to alpha,beta methylene-ATP. Papaverine left unaffected phase I but depressed the response to alpha,beta methylene-ATP. CEC significantly potentiated the purinergic component of the electrically-evoked response and the response induced by alpha,beta methylene-ATP. Nifedipine was devoid of any inhibitory action on the noradrenergic component (phase II) of the response to single shock. Verapamil at the highest concentration used (10(-5) M) was able to partially inhibit phase II. Papaverine abolished in a concentration-dependent manner the noradrenergic component of the response to single shock. CEC abolished the phase II of single shock while was devoid of any inhibitory action on exogenous noradrenaline. The implications of these differences among the compounds studied in the present work are discussed in relation to roles of calcium channels.

[Perioperative changes in the plasma levels of fibrinogen and D-dimer during laparoscopic cholecystectomy: the preliminary results of a prospective randomized clinical study]

AIM

Considering that laparoscopic procedure is associated with increased resistance to lower-limb venous return and subsequent stasis, with possible implications in terms of thromboembolic complications, the aim of our study was to investigate prospectively the coagulative-fibrinolytic profile, in laparoscopic and open cholecystectomy, in patients randomly alloted to receive or not preoperative heparin.

METHODS

We prospectively analyzed 36 patients (20 laparoscopic and 16 open) and we randomly divided the patients in two groups: Group-A (28 patients--16 laparoscopic and 12 open) didn't take any preoperative thromboprophylaxis, Group-B (8 patients--4 laparoscopic and 4 open) took preoperative subcutaneous heparin. We took blood venous samples before surgery, at time 0 and + 30 min., at the end and 1 and 24 hours postoperatively. The following parameters were assessed: prothrombin time, partial thromboplastin time, fibrinogen and D-dimer. We statistically analyzed the differences by ANOVA test.

RESULTS

In Group A, fibrinogen and D-dimer were significantly higher (p < 0.0001 and p = 0.0266) in open group as compared with laparoscopic one and we observed significant time-depending changes of fibrinogen's concentration (p = 0.0168). In Group B we obtained a higher fibrinogen's value in laparoscopic group than in conventional one, with a significant difference (p = 0.0283); also, the sampling-time affected the result in a very significant meaning (p = 0.0041). Comparing fibrinogen levels between Groups A and B, we observed lower values in heparin-treated group than in the other one (p < 0.0001), while in laparoscopic surgery there was not a significant difference between two groups of treatment.

CONCLUSIONS

Our preliminary data suggest that, perioperatively (besides a smaller laparoscopic acute-phase response) the coagulative-fibrinolytic changes are lower in laparoscopic cholecystectomy than in open one and heparin treatment significantly reduces these changes in open surgery but doesn't seem to affect laparoscopic group. Our results seem to show another possible advantage of the laparoscopic surgical procedures over the traditional ones.

Transplantation of pancreatic islets contained in minimal volume microcapsules in diabetic high mammalians

To minimize technical problems relating to excessive size (600-800 mu in diameter) of standard alginate microcapsules (CSM) for pancreatic islet graft immunoisolation, we have developed two novel minimal volume, chemically identical, capsule prototypes (MVC): 1) coherent microcapsules (CM), and 2) medium-size microcapsules (300-400 mu, MSM). CM, which envelop each individual islet within a thin alginate hydrogel cast, are prepared by emulsification, whereas MSM are made by atomizing the islet-alginate suspension through a special microdroplet generator. Upon graft into diabetic rodents, CM have shown to immunoprotect both allo- and xenogeneic nondiscordant islets, and restored normoglycemia. In higher mammals, at subtherapeutic doses, CM fully immunoprotected islet allografts (pig-->pig), but only temporarily xenografts (dog-->pig). We then used MSM to immunoisolate canine islet allografts in the peritoneal cavity of dogs with spontaneous insulin-dependent diabetes. Of three grafted dogs, two showed full remission of hyperglycemia with insulin withdrawal. MSM could represent an intermediate solution between CSM and CM for peritoneal immunoisolated islet transplants.

Effect of calcium antagonists on the response to noradrenaline in the whole and bisected rat vas deferens

1. The present study was carried out to look at the effect of different calcium antagonists on the response to noradrenaline in the whole and bisected rat vas deferens considering that the response consisted of three components (I) the phasic response (II) the tonic response and (III) the spikes (rhythmic contractions). 2. Nifedipine (3 x 10(-9)-1 x 10(-7) M) inhibited all the components at the same concentration range, verapamil (1 x 10(-7)-1 x 10(-5) M) inhibited the phasic and tonic response but not the rhythmic activity. This latter component, at a certain concentration range and especially in the prostatic portion was markedly potentiated. Diltiazem and flunarizine lay in an intermediate position. 3. Papaverine, a Ca2+ antagonist that acts mainly intracellularly, inhibited preferentially the tonic component; ryanodine was practically inactive. 4. Cromakalim inhibited only partially the phasic and tonic components but totally inhibited the rhythmic contractions. 5. These results can be explained by postulating two types of calcium channels opened by alpha-adrenoceptor stimulation. The first one is verapamil- and nifedipine-sensitive and allows the entry of Ca2+ directly available for the contraction and responsible for the phasic and partially responsible for the tonic component. The second channel is merely nifedipine-sensitive and allows the entry of Ca2+ trigger which can release Ca2+ from intracellular sites: the mobilized Ca2+ is able to sustain the tonic component and is the main one responsible for the rhythmic activity. There is the possibility that this second channel is associated with ATP-sensitive K+ channels.

["Hepatoid" gastric tumor]

In this study the Authors describe two cases of hepatoid adenocarcinoma of the stomach: one is characterized by the presence of alpha-fetoprotein (AFP) high levels of the serum both pre and post-operating and by the very positive response to the adjuvant chemotherapy (how the return to the normality of such values demonstrates). The other is instead characterized by the presence of post operating hepatic metastasis, event which is very frequent in this kind of neoplasm, but presents many problems concerning the differential histological diagnostics with the primitive hepatocarcinoma (problems which are nowadays not completely solved). Moreover the Authors relate to this study the revision of the international literature of the main characteristics and of prognosis of this particular and rare neoplasm.

Effect of cromakalim on the purinergic and cholinergic transmission in the rat detrusor muscle

Contraction of the rat detrusor muscle is mediated by cholinergic and purinergic mechanisms. The present study was carried out to look at the influence of cromakalim, compared with atropine, suramin and nifedipine on the contractile response evoked by single shock and exogenous agonists (carbachol and ATP) in rat urinary bladder. Cromakalim was able to inhibit only partially the response to carbachol and profoundly affected the response to exogenous ATP. Atropine suppressed the response to carbachol and was inactive versus ATP. Suramin was inactive versus carbachol and was able to antagonize the response to ATP. Nifedipine proved to be a non-competitive antagonist versus carbachol (pD2 = 7.66 +/- 0.05) and deeply affected the response to ATP. Cromakalim inhibited only partially the first, purinergic, phase of the electrically evoked response but was able to inhibit in a concentration-dependent manner the second, cholinergic, phase (logIC50 = 6.87 +/- 0.05). Nifedipine blocked both the phases. Atropine blocked partially only the second phase. Suramin inhibited the first phase but, at least partially, also the second one. The combination of atropine and suramin enhanced the inhibition of the second phase. The antagonistic effect of suramin on the second phase could indicate an overlap of the purinergic and cholinergic components. The comparison between pre- and postjunctional effects indicates that cromakalim acts on purinergic transmission predominantly postjunctionally. On the contrary, the action on cholinergic transmission seems to occur mainly at prejunctional level. This conclusion can be relevant in view of the claimed importance of K+ channel openers in the treatment of urinary disorders.

Profiles of the response to noradrenaline in the whole and bisected rat vas deferens

1. The present study was carried out to look at the differences between the whole and bisected rat vas deferens in response to cumulative and non-cumulative administration of noradrenaline in terms of sensitivity and maximum response. An effort was made to quantify the parameters characterizing the various components of the mechanical response to single concentrations of the agonist. 2. The sensitivity, as measured by the -log EC50 value for noradrenaline, was significantly lower in the prostatic portion than in the whole vas deferens and epididymal portion. The maximum contractions reached by the epididymal and the prostatic half were 65.03 +/- 10.43% and 13.84 +/- 5.28% of the maximal contraction evoked by noradrenaline in the whole rat vas deferens. 3. Various concentrations of noradrenaline were tested as single concentrations in the three preparations. These components of the response to noradrenaline were individualized, i.e. an early rapid phasic component followed by a second slower tonic component with spikes superimposed. The time-course of these components, as well as their ratios, were different depending on the concentration of agonist tested and on which half of the vas deferens was considered. 4. The importance of oxidation of exogenous noradrenaline as well of the neuronal and extraneuronal uptake mechanisms was considered. EDTA was devoid of any action. Cocaine enhanced potency and the maximum contraction of noradrenaline and all the parameters related to the different phases of the contraction were increased. Hydrocortisone at the highest concentration employed (2 X 10-5 M) was able to reduce significantly the -log EC50 value of the cumulative concentration-response curve to noradrenaline and both the phasic and tonic components of the contradiction to noradrenaline (3 X 10-6 M). 5. In conclusion, our evaluation of the parameters of the mechanical response of the whole and bisected vas deferens to noradrenaline rationalize the, often contradictory, findings of the current literature. Chiefly, the attainment of a careful description of the features of the response to noradrenaline can offer a dependable approach to the study of the underlying mechanisms of the three components.

Cromakalim blocks the purinergic response evoked in rat vas deferens by single-pulse electrical stimulation

The present study was carried out to look at the influence of the K+ channel opener cromakalim, compared with suramin and prazosin, on the contractile response evoked by single-pulse field stimulation and exogenous agonists in epididymal and prostatic portions of rat vas deferens. In the epididymal portion suramin abolished the first phase of the response to single shock, prazosin deeply affected the second phase and a combination of both antagonists almost completely abolished both phases. Cromakalim was able to inhibit in a concentration-dependent manner the first purinergic phase (pD2 = 5.90 +/- 0.11), leaving practically unaffected the second, adrenergic phase. This inhibitory effect of cromakalim on the electrically evoked response was counteracted by glibenclamide. Cromakalim and prazosin, but not suramin, affected the response to exogenous noradrenaline. Suramin but not cromakalim was able to antagonize responses to alpha, beta-methylene-ATP. In the prostatic portion because of a less clear discrimination between adrenergic and purinergic phases of the electrically evoked response, the picture was less clear although the trend was identical. Cromakalim was not able to antagonize the response to ATP. It is concluded that in rat vas deferens cromakalim inhibits purinergic transmission by acting prejunctionally.

Cholinergic agents structurally related to furtrethonium. 3. Synthesis and antimuscarinic activity of a series of N-(5-methyl-2-furfuryl and-tiophenyl)-dialkyl amines and of 2-dimethylamino methyl-4-(1'-substituted-acetoxy-methyl)-1,3-dioxolanes

The introduction of an homologous series of cyclic amines at position 2 of 5-methylfurane and its isoster 5-methylthiophene induced a weak antagonist behaviour, probably depending on the steric hindrance of the substituents at the nitrogen, in the case of the cardiac tissue. Surprisingly, when evaluated on guinea-pig ileum preparatons, these compounds showed non-muscarinic effects, not-related either to nicotinic or istaminergic effects, the nature of which awaits to be explained. Substitution of the furane ring on the structure of the lead 2a, b, obtained in a previous study, with the bioisoster 1,3-dioxolane moiety gave potent but not selective analogues (17 and 18).

Mode of antagonism of methoctramine, AF-DX 116 and hexahydrosiladifenidol in guinea-pig left atrium and ileum: comparison of Schild and resultant analysis

1. Methoctramine, AF-DX 116 and hexahydrosiladifenidol (HHSiD) are the muscarinic antagonists most widely used to study muscarinic receptor subtypes. 2. The present study was undertaken to examine the mode of antagonism of these compounds in guinea-pig left atrium and ileum by comparison of the Schild and resultant analysis. With this method the effect of various concentrations of the test antagonist on the antagonism produced by specific concentrations of a reference antagonist was measured and the equilibrium dissociation constant of the test antagonist-receptor complex estimated. Atropine was used for comparative purposes and scopolamine as the reference antagonist. 3. At the cardiac level the affinity values obtained by Schild and resultant analysis for methoctramine and AF-DX 116, as for atropine, are very similar: these results indicate that the two cardio-selective antagonists and the non-selective antagonist, atropine, bind at a common site with the reference antagonist scopolamine. The resultant plot for the ileo-selective HHSiD has a slope considerably less than unity: this finding might indicate that this antagonist binds to a site different from that of scopolamine and it should be considered like an allosteric antagonist. 4. At the ileal level the affinity values obtained by Schild and resultant analysis are identical for the ileo-selective antagonist HHSiD as for atropine but not for methoctramine and AF-DX 116. This indicates a mutual binding site with scopolamine for HHSiD and atropine but not for the two cardio-selective antagonists. However, it is worth emphasizing that the difference between affinity values obtained by Schild and resultant analysis is seen when relatively high concentrations are required: a dual mode of interaction (both competitive and allosteric) could be involved.

Synthesis and pharmacological investigation of new chiral muscarinic antagonists

The two pairs of enantiomers of isoxazolidin-3-ones 3 and 4 were synthesized by means of Lipase PS-catalyzed hydrolyses of suitable racemic butyrates. The same butyrates were also employed as key intermediates in the preparation of racemic 3 and 4. The antimuscarinic potency of the new compounds was assayed in two in vitro functional tests. The eutomers (-)-3 and (-)-4 share the same stereochemistry (5R) of the most potent enantiomer of "azamuscarone" 2, a structurally related muscarinic agonist. Such a spatial arrangement around the chiral center of 2-4, coupled with the low values of eudismic ratio, represents an anomaly among the chiral muscarinic ligands. This anomaly was accounted for by the absence of a chiral center at C-2, a position whose configuration is crucial in determining the high enantioselectivity of muscarinic agonists and antagonists.

Cholinergic agents structurally related to furtrethonium. 2. Synthesis and antimuscarinic activity of a series of N-[5-[(1'-substituted-acetoxy) methyl]-2-furfuryl]dialkylamines

In the first part of this study, devoted to the discovery of selective antimuscarinic agents, (+/-)- N-[5-[(1'-phenyl-1'-cyclohexylacetoxy)methyl]-2-furfuryl]dimeth yla mine (5a) proved to be at least 20 times more potent in the rat ileum and bladder than in guinea pig atria. Several (+/-)-N- [5-[(1'-substituted-acetoxy)methyl]-2-furfuryl]dialkylamine analogs of 5a were subsequently prepared. This involved exploration of the tertiary nitrogen substituents and modulation of the lipophilic side chain at position 5 of the furan ring, using the Hansch approach. A QSAR study was conducted to correlate activity with physicochemical properties of substituents. The possibility of describing all compounds in a single model indicates that variations of nitrogen and the lipophilic side chain contribute independently to activity. Compounds 5b, c,j, with bulky lipophilic substituents at the tertiary nitrogen, showed unprecedented selectivity between the two smooth muscle tissues, their antimuscarinic potency being from 10 to 90 times higher in the ileum than in the bladder. It is suggested that their interesting tissue selectivity is probably related to nonspecific phenomena involving the receptor environment, rather than real differences between the muscarinic receptors in the two tissues.

[Neoplastic involvement of the inferior vena cava]

Inferior caval vein invasion not infrequently complicates advanced neoplastic lesions. Primitive caval neoplasms (leiomyosarcomas) or other tumors such as renal carcinomas, pheochromocytoma, as well as liver, testis, and retroperitoneal tumors most likely cause caval invasion. In the past, caval invasion was a clear index of non operability, while today, a modern multidisciplinary approach allows to treat successfully even so advanced diseases. In the present report the Authors analyze the cases treated at the Dept. of Surgery of the University of Perugia, and review the most important international reports on this subject illustrating the new possibilities offered by IVC substitution with biological or artificial grafts.

Effect of cromakalim on spontaneous activity of castrated rat vas deferens

After castration rat vasa deferentia exhibited spontaneous activity. Cromakalim which acts by opening K+ channels has been shown to suppress this spontaneous activity following castration. Glibenclamide, a potent blocker of the ATP-sensitive K+ channels, inhibited this contrasting effect of cromakalim. The concentrations of cromakalim and glibenclamide that were employed are consistent with those active in different kinds of smooth muscle. The presented data are compatible with the hypothesis that castration decreases potassium conductance and that such an effect could be responsible for spontaneous activity.

[Surgical staplers in thoracic surgery]

Since its introduction in our department, in 1987, stapling devices are used on routine basis for thoracic surgery. Overall, 133 operations were performed: 95 lobectomies, 30 pneumonectomies, and 8 bilobectomies. Stapled related complications consisting of bronchopleural fistula following right pneumonectomy were registered in 3 cases. The use of vascular staplers was never associated with complications, and no air leakages following stapled parenchymal sutures were observed. The advantages related to the use of stapling devices are represented by low air leakage and bleeding rates, reduced operative trauma, and reduced operating time. However, confidence with the techniques is needed to avoid regrettable consequences.