Non-mechanical suture completely anatomic thoracoscopic lobectomy: A case control study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YANG Fan ¹ , ZHU Weipeng ¹ , CAO Jiashun ¹ , ZHAO Chuanduo ¹ , DONG Bing ² ,  CHEN Donghong ¹

1. Department of Thoracic Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, 102218, P.R.China;
2. Department of Cardiothoracic Surgery, The 305th Hospital of PLA, Beijing, 100017, P.R.China;

Corresponding author：

CHEN Donghong, Email: dr.chendonghong@aliyun.com

Keywords：

Video-assisted thoracic surgery; lobectomy; endoscopic stapler; manual suture

DOI：

10.7507/1007-4848.201805038

Video：

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Objective To investigate the safety and feasibility of thoracoscopic lobectomy without mechanical suture.Methods The data of 28 consecutive patients (a non-mechanical suture group, 16 males and 12 females at age of 61.23±11.10 years) who underwent non-mechanical suture anatomic thoracoscopic lobectomy performed by the same surgeon from March 2015 to March 2018 were analyzed retrospectively, and 28 patients (18 males and 10 females at age of 59.45±13.39 years) who underwent completely anatomic thoracoscopic lobectomy with endoscopic stapler (a mechanical suture group) in the same period were matched. The clinical effectiveness of the two groups was compared.Results The operation time between the non-mechanical suture group (136.30±53.46 min) and the mechanical suture group (109.63±44.61 min) showed a statistical difference (P<0.05). While in term of intraoperative bleeding volume (65.00 ml vs. 50.00 ml), postoperative thoracic drainage time (3.73 days vs. 3.56 days), thoracic drainage volume (538.60 ml vs. 563.70 ml), postoperative hospital stay (5.58 days vs. 5.35 days) and postoperative complication rate (5/28 vs. 6/28), there was no statistical difference between the two groups. Hospitalization expense was significantly different between the two groups (35 438.30 yuan vs. 51 693.60 yuan).Conclusion Non-mechanical suture thoracoscopic anatomic lobectomy is safe and feasible, and can significantly reduce the medical cost but prolong the operation time.

Citation： YANG Fan, ZHU Weipeng, CAO Jiashun, ZHAO Chuanduo, DONG Bing, CHEN Donghong. Non-mechanical suture completely anatomic thoracoscopic lobectomy: A case control study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(2): 116-120. doi: 10.7507/1007-4848.201805038 Copy

1.	Chen W, Sun K, Zheng R, et al. Cancer incidence and mortality in China, 2014. Chin J Cancer Res, 2018, 30(1): 1-12.
2.	Richardson MT, Backhus LM, Berry MF, et al. Intraoperative costs of video-assisted thoracoscopic lobectomy can be dramatically reduced without compromising outcomes. J Thorac Cardiovasc Surg, 2018, 155(3): 1267-1277.
3.	Oh DS, Reddy RM, Gorrepati ML, et al. Robotic-assisted, video-assisted thoracoscopic and open lobectomy: propensity-matched analysis of recent premier data. Ann Thorac Surg, 2017, 104(5): 1733-1740.
4.	Chen K, Wang X, Yang F, et al. Propensity-matched comparison of video-assisted thoracoscopic with thoracotomy lobectomy for locally advanced non-small cell lung cancer. J Thorac Cardiovasc Surg, 2017, 153(4): 967-976.
5.	刘德若,赵风瑞,王在永, 等. 器械与丝线缝合支气管和肺动静脉的比较研究. 中华胸心血管外科杂志, 2001, 17(4): 238-240.
6.	王兵,张德超,赫捷. 直线型缝合器在肺手术中的应用. 肿瘤防治杂志, 2005, 12(18): 1411-1412.
7.	Ito N, Suda T, Inoue T, et al. Use of a soft silicone tube guide for an automatic suture device in video-assisted lung lobectomy. J Thorac Cardiovasc Surg, 2005, 30(3): 931-932.
8.	Shao F, Liu Z, Pan Y, et al. Bronchoplasty using continuous suture in complete monitor view: a suitable method of thoracoscopic sleeve lobectomy for non-small cell lung cancer. World J Surg Oncol, 2016, 14: 134.
9.	Miyasaka Y, Oh S, Takahashi N, et al. Postoperative complications and?respiratory function following segmentectomy of the lung-comparison of the methods of making an inter-segmental plane. Interact Cardiovasc thorac Surg, 2011, 12(3): 426-429.
10.	Droghetti A, Schiavini A, Muriana P, et al. A prospective randomized trial comparing completion technique of fissures for lobectomy: staplerversus precision dissection and sealant. J Thorac Cardiovasc Surg, 2008 Aug, 136(2): 383-391.
11.	Marulli G, Droghetti A, Di Chiara F, et al. A prospective randomized trial comparing stapler and laser techniques for interlobar fissure completion during pulmonary lobectomy. Lasers Med Sci, 2013, 28(2): 505-311.
12.	D’Amico TA. Thoracoscopic segmentectomy: technical considerations and outcomes. Ann Thorac Surg, 2008, 85(2): S716-S718.
13.	Asakura K, Izumi Y, Kohno M, et al. Effect of cutting technique at the intersegmental plane during segmentectomy on expansion of the preserved segment: comparison between staplers and scissors in ex vivo pig lung. Eur J Cardiothorac Surg, 2011, 40(1): e34-e48.
14.	Yoshimoto K, Nomori H, Mori T, et al. Comparison of postoperative pulmonary function and air leakage between pleural closure vs mesh- cover for intersegmental plane in segmentectomy. J Cardiothorac Surg, 2011, 6: 61.
15.	Ohtsuka T, Goto T, Anraku M, et al. Dissection of lung parenchyma using electrocautery is a safe and acceptable method for anatomical sublobar resection. J Cardiothorac Surg, 2012, 7: 42.
16.	刘海波, 林钢, 张诗杰, 等. 电刀切割和机械切割在全胸腔镜肺段切除术段间平面分离中应用的对照研究. 中国肺癌杂志, 2017, 20(1): 41-46.
17.	Droghetti A, Marulli G, Vannucci J, et al. Cost analysis of pulmonary lobectomy procedure: comparison of stapler versus precision dissection and sealant. Clinicoecon Outcomes Res, 2017, 9: 201-206.

1. Chen W, Sun K, Zheng R, et al. Cancer incidence and mortality in China, 2014. Chin J Cancer Res, 2018, 30(1): 1-12.
2. Richardson MT, Backhus LM, Berry MF, et al. Intraoperative costs of video-assisted thoracoscopic lobectomy can be dramatically reduced without compromising outcomes. J Thorac Cardiovasc Surg, 2018, 155(3): 1267-1277.
3. Oh DS, Reddy RM, Gorrepati ML, et al. Robotic-assisted, video-assisted thoracoscopic and open lobectomy: propensity-matched analysis of recent premier data. Ann Thorac Surg, 2017, 104(5): 1733-1740.
4. Chen K, Wang X, Yang F, et al. Propensity-matched comparison of video-assisted thoracoscopic with thoracotomy lobectomy for locally advanced non-small cell lung cancer. J Thorac Cardiovasc Surg, 2017, 153(4): 967-976.
5. 刘德若,赵风瑞,王在永, 等. 器械与丝线缝合支气管和肺动静脉的比较研究. 中华胸心血管外科杂志, 2001, 17(4): 238-240.
6. 王兵,张德超,赫捷. 直线型缝合器在肺手术中的应用. 肿瘤防治杂志, 2005, 12(18): 1411-1412.
7. Ito N, Suda T, Inoue T, et al. Use of a soft silicone tube guide for an automatic suture device in video-assisted lung lobectomy. J Thorac Cardiovasc Surg, 2005, 30(3): 931-932.
8. Shao F, Liu Z, Pan Y, et al. Bronchoplasty using continuous suture in complete monitor view: a suitable method of thoracoscopic sleeve lobectomy for non-small cell lung cancer. World J Surg Oncol, 2016, 14: 134.
9. Miyasaka Y, Oh S, Takahashi N, et al. Postoperative complications and?respiratory function following segmentectomy of the lung-comparison of the methods of making an inter-segmental plane. Interact Cardiovasc thorac Surg, 2011, 12(3): 426-429.
10. Droghetti A, Schiavini A, Muriana P, et al. A prospective randomized trial comparing completion technique of fissures for lobectomy: staplerversus precision dissection and sealant. J Thorac Cardiovasc Surg, 2008 Aug, 136(2): 383-391.
11. Marulli G, Droghetti A, Di Chiara F, et al. A prospective randomized trial comparing stapler and laser techniques for interlobar fissure completion during pulmonary lobectomy. Lasers Med Sci, 2013, 28(2): 505-311.
12. D’Amico TA. Thoracoscopic segmentectomy: technical considerations and outcomes. Ann Thorac Surg, 2008, 85(2): S716-S718.
13. Asakura K, Izumi Y, Kohno M, et al. Effect of cutting technique at the intersegmental plane during segmentectomy on expansion of the preserved segment: comparison between staplers and scissors in ex vivo pig lung. Eur J Cardiothorac Surg, 2011, 40(1): e34-e48.
14. Yoshimoto K, Nomori H, Mori T, et al. Comparison of postoperative pulmonary function and air leakage between pleural closure vs mesh- cover for intersegmental plane in segmentectomy. J Cardiothorac Surg, 2011, 6: 61.
15. Ohtsuka T, Goto T, Anraku M, et al. Dissection of lung parenchyma using electrocautery is a safe and acceptable method for anatomical sublobar resection. J Cardiothorac Surg, 2012, 7: 42.
16. 刘海波, 林钢, 张诗杰, 等. 电刀切割和机械切割在全胸腔镜肺段切除术段间平面分离中应用的对照研究. 中国肺癌杂志, 2017, 20(1): 41-46.
17. Droghetti A, Marulli G, Vannucci J, et al. Cost analysis of pulmonary lobectomy procedure: comparison of stapler versus precision dissection and sealant. Clinicoecon Outcomes Res, 2017, 9: 201-206.

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Non-mechanical suture completely anatomic thoracoscopic lobectomy: A case control study

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