Menna Cecilia, Poggi Camilla, Andreetti Claudio, Ciccone Anna Maria, Baccarini Alberto Emiliano, Maurizi Giulio, D'Andrilli Antonio, Vanni Camilla, Cascone Roberto, Fiorelli Alfonso, Santini Mario, Venuta Federico, Rendina Erino Angelo, Ibrahim Mohsen
Division of Thoracic Surgery, Sapienza University of Rome, AOU Sant'Andrea, Rome, Italy.
Division of Thoracic Surgery, University of Campania Luigi Vanvitelli, Piazza Miraglia, 2, I-80138, Naples, Italy.
J Cardiothorac Surg. 2020 Jul 28;15(1):190. doi: 10.1186/s13019-020-01230-y.
Video-Assisted Thoracic Surgery (VATS) lobectomy is now considered the preferred approach at many centers for early stage lung cancer. However, it needs an adequate learning curve, and it may be challenging in non-expert hands. The aim of this study was to evaluate the effectiveness of Transcollation Technology over Traditional Electrocautery to perform hilar and mediastinal dissection during VATS lobectomy.
This is a single-center retrospective study including consecutive patients undergoing VATS lobectomy for lung cancer. Patients were divided in two groups based on whether Transcollation Technology (TT Group) or Traditional Electrocautery (TE Group) was used for hilar and mediastinal lymphadenectomy. Operative time and surgical outcome, including number of transfusions, length of chest drainage, length of hospital stay, morbidity and mortality were registered, and the inter-group differences were statistically analyzed.
53 patients were included in the final analysis. The TT Group (n = 24) compared to the TE Group (n = 29) showed significant shorter operative time (75.2 ± 25.8 min versus 98.1 ± 33.3 min; p = 0.023), and reduction of length of chest tube stay (4.7 ± 0.8 days vs. 6.8 ± 1.1 days, p = 0.013) and length of hospital stay (5.3 ± 1.9 days vs. 6.8 ± 1.1 days, p = 0.007). No intraoperative or major postoperative complications were observed in either groups.
Transcollation Technology represents a valid alternative to standard electrocautery instruments during VATS lobectomy. It contributes to reduce the operative time and length of hospital stay. Further larger prospective studies are required to confirm our data.
电视辅助胸腔镜手术（VATS）肺叶切除术目前在许多中心被认为是早期肺癌的首选手术方式。然而，它需要足够的学习曲线，在非专业人员操作时可能具有挑战性。本研究的目的是评估在VATS肺叶切除术中，经核对技术相较于传统电烙术在进行肺门和纵隔解剖方面的有效性。
这是一项单中心回顾性研究，纳入连续接受VATS肺癌肺叶切除术的患者。根据在肺门和纵隔淋巴结清扫中使用经核对技术（TT组）还是传统电烙术（TE组）将患者分为两组。记录手术时间和手术结果，包括输血量、胸腔引流时间、住院时间、发病率和死亡率，并对组间差异进行统计学分析。
最终分析纳入53例患者。与TE组（n = 29）相比，TT组（n = 24）的手术时间显著缩短（75.2±25.8分钟对98.1±33.3分钟；p = 0.023），胸腔引流管留置时间缩短（4.7±0.8天对6.8±1.1天，p = 0.013），住院时间缩短（5.3±1.9天对6.8±1.1天，p = 0.007）。两组均未观察到术中或术后严重并发症。
在VATS肺叶切除术中，经核对技术是标准电烙术器械的有效替代方法。它有助于缩短手术时间和住院时间。需要进一步开展更大规模的前瞻性研究来证实我们的数据。
