Dataset Information

Vessel sealing system for video-assisted lung resection for cancer reduces chylothorax and bleeding.

ABSTRACT:

Background

The objective of this study was to analyze the efficacy of the LigaSure^TM vessel sealing system for lung cancer resection with node dissection, as this has not been sufficiently evaluated.

Methods

From 2004 to 2018, 948 patients underwent anatomical pulmonary resection with node dissection for non-small cell lung carcinoma (NSCLC) via the video-assisted thoracoscopic surgery (VATS) approach. Medical records of these patients were reviewed retrospectively. Univariate and multivariate analyses were conducted to determine the risk factors for chylothorax and blood loss.

Results

Of the 948 patients, 318 (33.5%) who underwent anatomical lung resection with node dissection by conventional methods without vessel sealing system and 630 (66.5%) who underwent lung resection with node dissection with the vessel sealing system were included. The median intraoperative blood loss was 100 mL. Postoperative chylothorax occurred in 9 (2.8%) patients in the conventional method group with 2 (0.3%) patients in the vessel sealing system group (P=0.001). Patients in the vessel sealing group who developed chylothorax were cured by conservative treatment. Univariate and multivariate analyses identified male sex [odds ratio (OR) 2.053; 95% confidence interval (CI): 1.494-2.820; P<0.001] and the use of vessel sealing system (OR 0.342; 95% CI: 0.256-0.457; P<0.001) as independent predictors of intraoperative blood loss. The univariate and multivariate analyses identified the use of the vessel sealing system (OR 0.108; 95% CI: 0.023-0.504; P=0.005) as an independent predictor of chylothorax incidence.

Conclusions

Vessel sealing system for lung cancer resection could decrease chest tube duration, amount of intraoperative bleeding, and incidence of chylothorax in patients who undergo lung resection with node dissection.

SUBMITTER: Miyajima M

PROVIDER: S-EPMC8264714 | biostudies-literature | 2021 Jun

REPOSITORIES: biostudies-literature

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Publications

Vessel sealing system for video-assisted lung resection for cancer reduces chylothorax and bleeding.

Miyajima Masahiro M Maki Ryunosuke R Tada Makoto M Tsuruta Kodai K Takahashi Yuki Y Arai Wataru W Watanabe Atsushi A

Journal of thoracic disease 20210601 6

<h4>Background</h4>The objective of this study was to analyze the efficacy of the LigaSure<sup>TM</sup> vessel sealing system for lung cancer resection with node dissection, as this has not been sufficiently evaluated.<h4>Methods</h4>From 2004 to 2018, 948 patients underwent anatomical pulmonary resection with node dissection for non-small cell lung carcinoma (NSCLC) via the video-assisted thoracoscopic surgery (VATS) approach. Medical records of these patients were reviewed retrospectively. Uni ...[more]

PMID: 34277041

Similar Datasets

Project description:BackgroundThere has been increasing adoption of robot-assisted thoracic surgery (RATS) and uniportal video-assisted thoracic surgery (uVATS) for lung resection. We undertook a single-institution retrospective study, comparing these approaches.MethodsAn analysis was performed of patients who underwent lung resection by either uVATS or RATS. Operations were performed between July 1, 2020 and July 1, 2021. Two surgeons [one experienced in RATS, the other experienced in multi-portal VATS (mVATS), with the recent adoption of uVATS] performed all operations. Patients with known or suspected lung cancer or metastases were included. In addition to baseline characteristics, adverse events [as defined in the Society of Thoracic Surgeons (STS) General Thoracic Database], subjective pain scores (scale 1-10), and morphine equivalent dose (MED) requirement were compared for patients who remained in the hospital on post-operative days (POD) 1 to 4. For patients with lung cancer, recurrence rates, overall survival, and recurrence-free survival were evaluated.ResultsThere were 128 (50 uVATS and 78 RATS) patients. Although uVATS patients were older (70 versus 65 years; P=0.01), there was no difference in baseline forced expiratory volume in the first second (FEV1)%, diffusing capacity for carbon monoxide (DLCO)%, body mass index, and American Society of Anesthesiologists (ASA) scores. Mean procedure times and adverse event rates were similar. Four major complications occurred (all unanticipated return to the operating room). The 30- and 90-day mortality was zero. RATS was associated with shorter hospital stay (2.6 versus 4 days; P=0.02) and improved lymph node (15.3 versus 9.9; P=0.003) dissection. MED requirement was significantly reduced on POD 2-4 after uVATS, on both univariate and multivariate analysis. Ninety-four patients (uVATS; n=38, RATS; n=56) had primary lung cancer. Median follow-up was 15.6 months for these patients. Recurrence occurred in 4/34 (11.8%) uVATS and 7/56 (12.5%) RATS patients (P=0.77). There were no differences in overall survival or time to recurrence.ConclusionsUVATS and RATS lung resections were associated with similar post-operative adverse event rates. Lymph node dissection and length of stay were improved with RATS. Oncological outcomes were similar. UVATS was associated with lower morphine requirement. Prospective studies will help further clarify the differences between these approaches.

Dataset Information

Vessel sealing system for video-assisted lung resection for cancer reduces chylothorax and bleeding.

Background

Methods

Results

Conclusions

Publications

Vessel sealing system for video-assisted lung resection for cancer reduces chylothorax and bleeding.

Similar Datasets

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