Details

Autor(en) / Beteiligte

• Catelli, Chiara
• D’Alessandro, Miriana
• Mathieu, Federico
• Addamo, Emanuele
• Franchi, Federico
• Paladini, Piero
• Luzzi, Luca

Titel

Clinical and biological effects of different energetic surgical devices currently used for mini-invasive anatomical lung resections for the treatment of NSCLC: a prospective interventional study

Ist Teil von

• Surgical endoscopy, 2024-08, Vol.38 (8), p.4753-4761

Ort / Verlag

New York: Springer US

Erscheinungsjahr

2024

Quelle

MEDLINE

Beschreibungen/Notizen

• Background This study aims to compare three commonly used energy devices for dissection during Video-Assisted Thoracoscopic Surgery (VATS) lobectomy: monopolar hook, advanced bipolar, and ultrasonic device, in terms of duration of the surgical procedure and clinical intra- and post-operative outcomes. Materials and methods In this prospective single-center study, 75 patients undergoing VATS lobectomy for non-small cell lung cancer between January 2022 and May 2023 were enrolled and divided into 3 groups based on the device used during the surgical procedure (Group 1: Ultrasonic Device, Group 2: Advanced Bipolar, Group 3: Monopolar Hook). The duration of the surgical procedure, daily pleural fluid production, post-operative pain, length of hospital stay, and occurrence of post-operative complications were compared for each group. In a subgroup of 20 patients (10 from Group 1 and 10 from Group 3), concentrations of inflammatory cytokines in pleural fluid at 3 h and 48 h post-surgery were analyzed. Results Pleural fluid production on the first and second post-operative days was significantly lower in patients treated with the Ultrasonic device compared to the other two groups ( p  < 0.001). The duration of the surgical procedure was significantly shorter when using the Ultrasonic device ( p  < 0.001). There were no significant differences in length of hospital stay ( p  = 0.975), pain on the first and second post-operative days ( p  = 0.147 and p  = 0.755, respectively), and blood hemoglobin levels on the first post-operative day ( p  = 0.709) and at discharge ( p  = 0.795). No differences were observed in terms of post-operative complications, although the incidence of post-operative cardiac arrhythmias was borderline significant ( p  = 0.096), with no cases of arrhythmias recorded in Group 1. IL-10 levels in pleural fluid of patients in Group 3 peaked at 3 h post-surgery, with a significant reduction at 48 h ( p  = 0.459). Discussion The use of the ultrasonic device during VATS lobectomy may reduce pleural fluid production and shorten the duration of the surgical procedure compared to using a monopolar hook or advanced bipolar device. The choice of energy device may influence the local inflammatory response, although further studies are needed to confirm these results.