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Prospective feasibility study of sealing pulmonary vessels with energy in lung surgery.
- Source :
-
The Journal of thoracic and cardiovascular surgery [J Thorac Cardiovasc Surg] 2019 Jan; Vol. 157 (1), pp. 388-395. Date of Electronic Publication: 2018 Apr 30. - Publication Year :
- 2019
-
Abstract
- Objective: Vascular sealing with an energy vessel sealing system during lung resection may allow surgeons to treat small vessels with minimal dissection, possibly decreasing likelihood of injury. Few large prospective trials have examined the proximal sides of vessels not ligated in addition to sealing during surgery. We therefore assessed feasibility of an energy device to seal pulmonary artery and vein branches without further ligation.<br />Methods: This prospective, preoperative registration study at 2 institutions evaluated safety of energy sealing with the LigaSure (Medtronic, Minneapolis, Minn), with no additional reinforcing material such as suture ligation, for pulmonary vessels as large as 7 mm during anatomic lung resection (cohort 1 study). A postoperative hemorrhage occurred in the 128th case, so a cohort 2 study proceeded after we changed inclusion criterion for pulmonary arteries from a maximum of 7 mm to a maximum of 5 mm.<br />Results: In cohort 1 (n = 128) and cohort 2 (n = 200), 216 and 250 pulmonary arteries and 189 and 213 pulmonary veins, respectively, were treated with energy sealing. Overall postoperative hemorrhage rate was 0.3% (1/328 patients); however, no serious postoperative complications were associated with energy sealing among the 200 patients in cohort 2. Subsequent inspection of the torn artery stump confirmed that the bleeding in the 128th case was in an area adjacent to the sealing zone.<br />Conclusions: Energy sealing without reinforcement allows secure treatment during lung resection of pulmonary arteries as large as 5 mm in diameter and pulmonary veins as large as 7 mm.<br /> (Copyright © 2018 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Feasibility Studies
Female
Humans
Lung Neoplasms surgery
Male
Middle Aged
Pneumonectomy adverse effects
Postoperative Hemorrhage epidemiology
Postoperative Hemorrhage etiology
Postoperative Hemorrhage prevention & control
Prospective Studies
Lung surgery
Pneumonectomy methods
Pulmonary Artery surgery
Pulmonary Veins surgery
Tissue Adhesives therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1097-685X
- Volume :
- 157
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- The Journal of thoracic and cardiovascular surgery
- Publication Type :
- Academic Journal
- Accession number :
- 30415901
- Full Text :
- https://doi.org/10.1016/j.jtcvs.2018.02.113