Local Recurrence After Sublobar Resection for Primary Lung Cancer: Does the Type of Stapling Device Matter?

Two major types of stapling devices exist: those with disposable built-in knives and those with nondisposable built-in knives. This study investigated whether the stapler type influences the incidence of local recurrence, including margin recurrence and pleural dissemination, after curative sublobar resection for lung cancer.

We retrospectively reviewed patients who underwent sublobar resection at our institution between 2010 and 2021. We compared disease-free survival, overall survival, and local recurrence between procedures using a stapler with a disposable knife and those using a stapler with a nondisposable knife.

A total of 269 patients were included: 84 were treated with the disposable-knife stapler and 185 with the nondisposable-knife stapler. Local recurrence occurred in 22 of 269 patients (8.2%), including 9 of 84 (10.7%) in the disposable group and 13 of 185 (7.0%) in the nondisposable group (P = .72). Patients who developed local recurrence tended to be older, male, have a smoking history, squamous cell carcinoma, absence of a ground-glass component, positive stapling cartridge cytology, partial resection, right lower lobe tumours, elevated carcinoembryonic antigen, and higher maximum standardized uptake values. In a propensity score-matched study (78 patients per group), no significant differences in disease-free survival, overall survival, or local recurrence were detected between the stapler types.

No statistically significant differences in oncological outcomes were observed between stapler types in this retrospective study; however, the absence of a significant difference does not rule out a real effect. Further large-scale research is warranted.