Comparing bipolar electrothermal device and endostapler in endoscopic lung wedge resection

• Published in: Interactive cardiovascular and thoracic surgery 2009-07, Vol.9 (1), p.11-14
• Main Authors: Kovacs, Otto, Szanto, Zoltan, Krasznai, Geza, Herr, Gyorgy
• Format: Article
• Language: English
• Subjects: Cost-Benefit Analysis; Electrocoagulation - adverse effects; Electrocoagulation - economics; Electrocoagulation - instrumentation; Equipment Design; Feasibility Studies; Female; Humans; Length of Stay; Lung Neoplasms - surgery; Male; Middle Aged; Pneumonectomy - adverse effects; Pneumonectomy - economics; Pneumonectomy - instrumentation; Retrospective Studies; Solitary Pulmonary Nodule - surgery; Surgical Staplers - economics; Surgical Stapling - adverse effects; Surgical Stapling - economics; Surgical Stapling - instrumentation; Thoracic Surgery, Video-Assisted - adverse effects; Thoracic Surgery, Video-Assisted - economics; Thoracic Surgery, Video-Assisted - instrumentation; Time Factors; Treatment Outcome
• ISSN: 1569-9293; 1569-9285
• DOI: 10.1510/icvts.2008.199307

a Department of Thoracic-Vascular and General Surgery, County Hospital Szolnok, Hungary b Department of Pathology, County Hospital Szolnok, Hungary *Corresponding author. Department of Surgery, Hetényi County Hospital, Tószegi u. 21, Szolnok 5000, Hungary. Tel.: [phone]; fax: [phone]. E-mail address : surgic{at}freemail.hu (Z. Szántó). Video-assisted thoracoscopy (VATS) is gaining on thoracic surgery, having newly developed devices next to endostaplers for haemostatic and airtight sealing of lung parenchyma. Though the bipolar electrothermal Ligasure has good results for pulmonary wedge resection, its literature is small in numbers. Authors compared Ligasure and endostapler for pulmonary wedge resection of solitary pulmonary nodules (SPN). Authors performed a retrospective analysis of 44 consecutive patients. The indication of operation was non-verified SPN in all cases. They carried out pulmonary wedge resection for 22 patients with Ligasure–Atlas and 22 patients with ETS Flex endostapler via VATS. Authors examined the gender, average age (62 vs. 49 years), mean hospital stay (6.6 vs. 6.8 days), average operation time (55 vs. 50 min), number of complications (2 vs. 1), average drainage time (2.8 vs. 2.7 days), average fluid loss (190 vs. 160 ml), and instrumental costs ( 367 vs.  756) of both groups. They accomplished the histological analysis of the coagulated lung parenchyma as well. According to the results, the Ligasure–Atlas is eligible for pulmonary wedge resection. The method is safe, easy to use, having minimal rate of complications. It can moderate costs of operation, compared to endostaplers. Key Words: Video-assisted thoracoscopy; Solitary pulmonary nodules; Wedge resection; Ligasure; Low costs