Abstract: Objective To investigate the application of a silicone guiding tube for endoscopic linear stapling device in complete video-assisted thoracoscopic lobectomy and segmentectomy,so as to improve the safety and efficiency of manipulating the endoscopic linear stapling device. Methods We retrospectively analyzed clinical data of 178 patients with peripheral non-small cell lung caner and 26 patients with benign lung lesions who underwent surgical resection in First Affiliated Hospital of Nanjing Medical University from October 2009 to December 2011. There were 85 males and 119 females with their average age of 62±11 years. A total of 172 patients underwent complete video-assisted thoracoscopic lobectomy and 32 patients underwent segmentectomy. We designed a silicone guiding tube to facilitate the use of endoscopic linear stapling device. With the help of the tube, a1l pulmonary arteries, veins, bronchus and interlobar fissure involved were managed with endoscopic linear stapling devices. Results Three patients (1.47%)underwent conversion to thoracotomy because of dense lymph node adhesion, and all other complete video-assisted thoracoscopic surgeries were successfully performed. There was no blood vessel injury, severe postoperative complications or perioperative death. The use rate of the tube was 95.6% (303/317), 66.9% (115/172), 22.7% (39/172) and 78.5% (255/325) in pulmonary arteries, veins, bronchus and interlobar fissure stapling for lobectomy respectively, and 94.4% (34/36), 77.3% (17/22), 25.0% (8/32), 33.1% (45/136) in pulmonary arteries, veins, bronchus and interlobar fissure stapling for segmentectomy respectively. For lobectomy, a total of 986 staples were used with an average of 5.7 staples for each patient, the average operative time was 192.5±54.0 min and average intraoperative blood loss was 118.1±104.1 ml. For segmentectomy, a total of 226 staples were used with an average of 7.1 staples for each patient, the average operative time was 193.7±37.4 min and average intraoperative blood loss was 60.9±78.0 ml. Conclusion Using a silicone guiding tube can facilitate the application of endoscopic linear stapling device, shorten the learning curve of complete video-assisted thoracoscopic lobectomy and segmentectomy, and improve the safety, convenience and economical efficiency of endoscopic linear stapling device.
Citation: WU Weibing,CHEN Liang,ZHU Quan,ZHANG Shijiang,SHAO Yongfeng.. Application of A Silicone Guiding Tube for Endoscopic Linear Stapling Device in Complete Video-Assisted ThoracoscopicLobectomy and Segmentectomy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2012, 19(6): 638-641. doi: Copy
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