1.Electrocautery versus Stapler for Intersegmental Plane Dissection in Complete Thoracoscopic Segmentectomy
LIU HAIBO ; LIN GANG ; ZHANG SHIJIE ; HUANG WEIMING ; SHANG XUEQIAN ; LI JIAN
Chinese Journal of Lung Cancer 2017;20(1):41-46
Background and objective Complete thoracoscopic segmentectomy gained great attention with the high detection rate of early lung cancer. Electrocautery and stapler are most commonly used in dividing the intersegmental plane in pulmonary segmentectomy. However, few reports comparing the two methods exist;all of which contrapose an open approach because complete thoracoscopic approach is not mentioned. hTe aim of this study is to evaluate and compare the safety and effcacy of the two methods in intersegmental plane dissection during complete thoracoscopic pulmonary segmen-tectomy. Methods A retrospective review of prospectively collected data was obtained for 58 consecutive patients who were treated by segmentectomy between September 2013 and March 2016 at a single center. hTe patients were divided into two groups according to the methods in intersegmental plane dissection. hTirty patients underwent intersegmental plane dissection with electrocautery (electrocautery group), and 28 patients underwent the same process using staplers (stapler group). Pre-operative, intraoperative, and postoperative variables for patients were compared between two groups. Results hTe operative time of electrocautery group was longer than that of the stapler group [(248.70±54.46) min vs (209.39±67.25) min, P=0.017]. Furthermore, no statistical difference was found between two groups in intraoperative blood loss (60.00 mL vs 65.00 mL), total drainage volume (445.00 mL vs 590.00 mL), drainage volume in ifrst 3 days atfer surgery [(455.33±318.333) mL vs (422.32± 194.95) mL], duration of chest tube drainage [(4.20±2.07) d vs (4.11±1.61) d], postoperative hospital stay [(6.33±2.98) d vs (5.89±1.55) d], and incidence of minor postoperative complication [16.7%(5/30) vs 7.1%(2/28)]. Conclusion Although operative time was longer in electrocautery group than in stapler group, using electrocautery for intersegmental plane dissec-tion in complete thoracoscopic segmentectomy appeared to be a very safe and feasible procedure compared with stapler.