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Methods for Dissecting Intersegmental Planes in Segmentectomy: A Randomized Controlled Trial.

Xingshi Chen1, Runsen Jin1, Jie Xiang1

  • 1Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai.

The Annals of Thoracic Surgery
|March 16, 2020
PubMed
Summary
This summary is machine-generated.

Stapler devices significantly reduce postoperative complications in pulmonary segmentectomy compared to electrocautery. This method for dissecting intersegmental planes improves patient outcomes without impacting lung function or overall costs.

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Area of Science:

  • Thoracic Surgery
  • Surgical Innovation
  • Pulmonary Medicine

Background:

  • The optimal method for dissecting intersegmental planes during pulmonary segmentectomy remains debated.
  • Comparing stapling devices and electrocautery for this procedure is crucial for patient outcomes.

Purpose of the Study:

  • To compare the perioperative outcomes of using stapling devices versus electrocautery for intersegmental plane dissection in pulmonary segmentectomy.
  • To evaluate the incidence of postoperative complications and other key surgical outcomes.

Main Methods:

  • A single-center, prospective, participant-blinded, randomized controlled trial (NCT03192904) was conducted.
  • The study enrolled 70 patients and focused on the primary outcome of postoperative complications.
  • Secondary outcomes included operative duration, blood loss, drainage, hospital stay, lung function, and costs.

Main Results:

  • The trial was stopped early due to a significant difference in postoperative complications.
  • Stapler device use resulted in a lower incidence of complications (6.1%) compared to electrocautery (34.4%).
  • No significant differences were observed in operative time, blood loss, drainage, hospital stay, or lung function; however, material costs were higher with staplers.

Conclusions:

  • Stapler devices are superior to electrocautery for dissecting intersegmental planes in pulmonary segmentectomy, significantly reducing postoperative complications.
  • This approach does not compromise lung function or increase overall economic burden.
  • The findings support the use of stapler devices for improved patient safety in segmentectomy procedures.