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• 12495

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  P3.07 - Poster Session 3 - Surgery (ID 193)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12499

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    P3.07-004 - A novel soft-coagulation system for lung cancer surgery: minimization of surgeons' risk (ID 227)

    09:30 - 09:30  |  Author(s): K. Nakamura
    • Abstract

    Background
    The soft-coagulation system VIO is a new device for tissue coagulation in which the output voltage is automatically regulated. This system controls the temperature below the boiling point, without generating sparks, thereby causing minimal damage to surrounding tissues. This study was designed to evaluate the usefulness of a soft-coagulation system for lung cancer surgery in the viewpoint of minimizing surgeons’ risk.

    Methods
    We used soft-coagulation system VIO (ERBE Elektromedizin, Tubingen, Germany) for major pulmonary resections in 223 consecutive patients with primary lung cancer from January 2009 through April 2013. Bipolar soft-coagulation mode was used for tissue coagulation around lobar vessels, fissure dissection, and lymph node dissection. Three general thoracic surgeons were enrolled in this study. The checkpoints included blood loss, incidence of intraoperative complications, and surgeons’ stress. The data among the 223 patients who underwent major pulmonary resections using the VIO system (VIO group) were compared with data on 122 patients with primary lung cancer who underwent major pulmonary resection in our institution between January 2006 and December 2008 using conventional electrocautery (CE group). Student’s t-test was used to examine intergroup difference in blood loss. The threshold of significance was set at P<0.05).

    Results
    The patients consisted of 116 men and 107 women with a median age of 70.3 years. The type of resection was lobectomy in 200 patients, bilobectomy in 5, pneumonectomy in 6, and segmentectomy in 12. All pulmonary resections were performed by thoracotomy. Thoracoscopy was used in all cases for assistance. The pathological stage was stage IA in 129, IB in 43, IIA in 8, IIB in 14, IIIA in 24, IIIB in none, and IV in 4. With the VIO system, coagulation of tissues around the lobar vessels was effective without injury to the pulmonary vessels or bronchus. The mean blood loss in the VIO group was 76.1 g (range 5-700 g), which was significantly lower than that in the CE group (mean 175.3 g, range 5-1580 g) (P<0.0001). There was no intraoperative complication. The interview has shown that all three surgeons experienced less stress in surgery with soft-coagulation system, compared to surgery with CE.

    Conclusion
    The results of this study showed that the VIO soft-coagulation system is safe and feasible for major pulmonary resections in patients with primary lung cancer. This device could contribute to improve safety during dissection of the lobar vessels and decrease the surgeons’ risk in lung cancer surgery.