Yoshida Kazuo, Toishi Masayuki, Eguchi Takashi, Saito Gaku, Shiina Takayuki, Kondo Ryoichi, Amano Jun
Department of Thoracic Surgery, School of Medicine, Shinshu University, Matsumoto, Nagano, Japan.
Ann Thorac Cardiovasc Surg. 2014;20(5):353-8. doi: 10.5761/atcs.oa.13-00014. Epub 2013 Oct 3.
Despite recent advances in video-assisted thoracoscopic lobectomy, some technical limitations still remain. Our current study purpose was to determine if the vessel sealing system (VSS) has utility in this procedure.
112 patients who underwent an anatomic pulmonary lobectomy at our institute were evaluated retrospectively. The burst pressure of pulmonary vessels, which was divided into VSS (VSS group; n = 44) or manual ligature (ligature group; n = 53) groups, was measured experimentally in transected lungs. Perioperative clinical data was also retrospectively evaluated in patients treated with (VSS group) or without using VSS (n-VSS group).
Burst pressures achieved adequate strength in both the VSS (600.0 ± 436.8 mmHg) and ligature (1057.4 ± 462.3 mmHg) groups. Compared with the n-VSS group, the VSS group patients showed lower intraoperative blood loss (115.4 ± 181.1 vs. 183.3 ± 159.1 ml), lower chest fluids by 3rd post-operative day (POD) (533.8 ± 264.8 vs. 705.3 ± 339.3 ml) and a shorter period of chest tube duration (4.1 ± 1.2 vs. 5.4 ± 2.4 days). No serious complications or perioperative (30 days) deaths occurred in either group.
The VSS device has the advantage in pulmonary lobectomy procedures, especially those involving video-assisted thoracic surgery (VATS).
尽管电视辅助胸腔镜肺叶切除术最近取得了进展，但仍存在一些技术限制。我们当前的研究目的是确定血管封闭系统（VSS）在此手术中是否有用。
对在我们研究所接受解剖性肺叶切除术的112例患者进行回顾性评估。在离体肺中通过实验测量肺血管的破裂压力，将其分为VSS组（VSS组；n = 44）或手工结扎组（结扎组；n = 53）。还对接受（VSS组）或未使用VSS（非VSS组）治疗的患者的围手术期临床数据进行回顾性评估。
VSS组（600.0±436.8 mmHg）和结扎组（1057.4±462.3 mmHg）的破裂压力均达到足够强度。与非VSS组相比，VSS组患者术中失血量更低（115.4±181.1 vs. 183.3±159.1 ml），术后第3天胸腔引流量更低（533.8±264.8 vs. 705.3±339.3 ml），胸管留置时间更短（4.1±1.2 vs. 5.4±2.4天）。两组均未发生严重并发症或围手术期（30天）死亡。
VSS设备在肺叶切除术中具有优势，尤其是在电视辅助胸腔镜手术（VATS）中。
