Oxidized regenerated cellulose for a clear thoracoscopic view: a single-centre randomized trial

Area of Science:

• Thoracic Surgery
• Surgical Hemostasis
• Minimally Invasive Procedures

Background:

• Blood oozing from access port wounds during VATS can compromise surgical visualization.
• Effective hemostasis is crucial for maintaining a clear operative field and ensuring patient safety.

Purpose of the Study:

• To evaluate the efficacy of oxidized regenerated cellulose (ORC) wound edge protectors in reducing blood oozing during VATS.
• To compare operative outcomes between VATS procedures with and without ORC application.

Main Methods:

• A prospective, single-centre, open-label, randomized clinical trial was conducted.
• 108 patients undergoing VATS were randomized into an ORC group (n=54) and a non-ORC group (n=54).
• Primary endpoint: interruption of operation due to wound bleeding; secondary endpoints: intraoperative and postoperative outcomes.

Main Results:

• The ORC group experienced significantly fewer operational interruptions due to bleeding (11.1% vs 51.8%, P<0.001).
• Hemostasis of access ports during closure was required less often in the ORC group (44.4% vs 72.2%, P=0.003).
• Postoperative outcomes were similar, with a trend towards shorter operation times in the ORC group (149.3 vs 168.8 min, P=0.083).

Conclusions:

• ORC sheets applied to wound edge protectors effectively achieve hemostasis during VATS.
• This technique ensures a clearer surgical view, potentially improving operative efficiency and safety in VATS procedures.