亜葉切除における切断面分割のためのエネルギーデバイスの使用

The use of energy devices for the division of cutting planes in sublobectomy remains controversial, especially in terms of postoperative complications. The aim of this study is to evaluate the safety and feasibility of this technique in patients undergoing sublobectomy.

A cohort of 69 patients who had received sublobectomy was retrospectively enrolled. The cutting planes were dissected by energy devices without a stapler in all the surgeries. An analysis was conducted of the clinical, pathological, and surgical parameters, along with the postoperative course of recovery. Expansion of the residual lung was evaluated 3 and 6 months after surgery.

The average age of the patients was 51.4 years and over three quarters of them were female, non-smokers. All the surgeries were done by uni-portal video-assisted thoracoscopic surgery with the mean operation time being 124.9 minutes and an average blood loss of 25.9 mL. The overall complication rate was 13% (9/69), with prolonged air leak being most common (7.2%, 5/69). The mean time of chest tube drainage and hospital stay after surgery was 3.5 and 3.8 days, respectively. Full remnant lung expansion was obtained in 65.1% (41/63) of the patients at three-month follow-up after surgery. At 6-month follow-up, the rate of full lung expansion of the patients rose to 90.5% (57/63).

It is safe and feasible to divide the cutting plane by energy devices during sublobectomy for selected patients.