Author of

• 15343

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  P3.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 214)

  • Event: WCLC 2015
  • Type: Poster
  • Track: Treatment of Locoregional Disease – NSCLC
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)

  • 15353

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    P3.03-010 - Usefulness of Vessel Sealing Devices in Thoracoscopic Lobectomy for Lung Cancer (ID 825)

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

    Background:
    Vessel sealing devices (VSD) are widely used for various surgical procedures. They are regarded as useful in thoracoscopic surgery, but few reports have substantiated this belief by comparison with non-use of VSD in human thoracoscopic lobectomy. Aiming to establish a simpler and safer thoracoscopic lobectomy, we examined the usefulness of VSDs.
    
    Methods:
    Primary lung cancer patients for whom a thoracoscopic lobectomy involving mediastinal lymph node dissection was planned in our department from April 2011 to June 2013 were recruited for the study. Patients were randomly allocated to a control group (n=15) or a VSD group (n=46), which constituted of three subgroups, namely, EnSeal (n=17), LigaSure (n=15), and Harmonic (n=14). The control group comprised of patients undergoing surgery solely with ligation and conventional electrocautery. EnSeal, LigaSure, and Harmonic were chosen because they are the 3 most popular disposable VSDs used in Japan. Primary endpoints were burst pressure of the pulmonary artery stump (measured using resected specimens), operative time, intraoperative blood loss, instances of endostapler use, intraoperative surgeon stress (assessed by visual analog scale), and postoperative drainage volume and duration. As a secondary objective, the individual VSD groups were also compared with each other.
    
    Results:
    The burst pressure of ligation-treated pulmonary artery stumps was higher than that of VSD-treated stumps (P<0.0001). The burst pressure of < 5-mm wide VSD-treated stumps was higher than that of ≥ 5 mm wide stumps (P=0.0359). However, burst pressure for all groups and all vessel diameters was sufficient to withstand physiological pulmonary artery pressure. The VSD group demonstrated reduced intraoperative blood loss (P=0.0174), surgeon stress (P=0.0001), postoperative drainage volume (P=0.0270), and shortened postoperative drainage duration (P=0.0330). Operative time and the instances of endostapler use did not significantly differ. Comparison between each of the VSD groups revealed no significant differences. None of the patients experienced serious perioperative complications or died because of surgery.
    
    Conclusion:
    VSD is simple and safe to use in thoracoscopic lobectomy involving mediastinal lymph node dissection for primary lung cancer. Further, none of the VSDs used in this study presented any observable differences in quality that could lead to clinical problems.