Does fissure status affect the outcome of thoracoscopic pulmonary lobectomy?

Purpose We studied fissure status and devices used to divide lung parenchyma during thoracoscopic pulmonary lobectomy (TPL). Methods 52 consecutive TPL indicated for congenital pulmonary airway malformation or interlobar pulmonary sequestration performed between 2009 and 2019 were reviewed prospecti...

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Veröffentlicht in:Pediatric surgery international 2020, Vol.36 (1), p.57-61
Hauptverfasser: Murakami, Hiroshi, Koga, Hiroyuki, Lane, Geoffrey, Hirayama, Shunki, Suzuki, Kenji, Yamataka, Atsuyuki
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container_issue 1
container_start_page 57
container_title Pediatric surgery international
container_volume 36
creator Murakami, Hiroshi
Koga, Hiroyuki
Lane, Geoffrey
Hirayama, Shunki
Suzuki, Kenji
Yamataka, Atsuyuki
description Purpose We studied fissure status and devices used to divide lung parenchyma during thoracoscopic pulmonary lobectomy (TPL). Methods 52 consecutive TPL indicated for congenital pulmonary airway malformation or interlobar pulmonary sequestration performed between 2009 and 2019 were reviewed prospectively to compare patients with absent fissure and no visible interlobar pulmonary artery (IPA) treated by stapling (group A; n  = 10), incomplete fissure with partially visible IPA treated with an Enseal ® or LigaSure™ device (group I; n  = 17), and complete fissure with fully visible IPA treated by electrocautery (group C; n  = 25). Results Patient demographics were similar. Mean age at TPL was 2.82 years (range 0.03–9.81). Mean duration of follow-up was 4.77 years (range 0.33–10.19). Operative time and duration of chest tube insertion were similar ( p  = NS). Intraoperative blood loss was significantly lower in group C compared with group I ( p  = 0.028). Complications were minor bronchial artery hemorrhage during anterior-to-posterior bronchial dissection (group A: n  = 1; group I: n  = 1), problematic single lung ventilation (group I: n  = 1), and persistent postoperative air leak (group I: n  = 1). Conclusion While fissure status does not appear to affect the outcome of TPL in children, the choice of device for dividing lung parenchyma relies specifically on fissure status.
doi_str_mv 10.1007/s00383-019-04577-z
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Methods 52 consecutive TPL indicated for congenital pulmonary airway malformation or interlobar pulmonary sequestration performed between 2009 and 2019 were reviewed prospectively to compare patients with absent fissure and no visible interlobar pulmonary artery (IPA) treated by stapling (group A; n  = 10), incomplete fissure with partially visible IPA treated with an Enseal ® or LigaSure™ device (group I; n  = 17), and complete fissure with fully visible IPA treated by electrocautery (group C; n  = 25). Results Patient demographics were similar. Mean age at TPL was 2.82 years (range 0.03–9.81). Mean duration of follow-up was 4.77 years (range 0.33–10.19). Operative time and duration of chest tube insertion were similar ( p  = NS). Intraoperative blood loss was significantly lower in group C compared with group I ( p  = 0.028). Complications were minor bronchial artery hemorrhage during anterior-to-posterior bronchial dissection (group A: n  = 1; group I: n  = 1), problematic single lung ventilation (group I: n  = 1), and persistent postoperative air leak (group I: n  = 1). Conclusion While fissure status does not appear to affect the outcome of TPL in children, the choice of device for dividing lung parenchyma relies specifically on fissure status.</description><identifier>ISSN: 0179-0358</identifier><identifier>EISSN: 1437-9813</identifier><identifier>DOI: 10.1007/s00383-019-04577-z</identifier><identifier>PMID: 31555863</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Blood Loss, Surgical ; Child ; Child, Preschool ; Dissection ; Electrocoagulation ; Female ; Hemostasis, Surgical - instrumentation ; Hospital costs ; Humans ; Infant ; Infant, Newborn ; Lung - pathology ; Lung - surgery ; Male ; Medicine ; Medicine &amp; Public Health ; Original Article ; Patients ; Pediatric Surgery ; Pediatrics ; Pneumonectomy - methods ; Postoperative Complications ; Prospective Studies ; Pulmonary arteries ; Surgery ; Surgical Stapling ; Thoracic surgery ; Thoracoscopy ; Veins &amp; arteries ; Ventilators</subject><ispartof>Pediatric surgery international, 2020, Vol.36 (1), p.57-61</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2019</rights><rights>Pediatric Surgery International is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-ea2cfafda6f59e50c2733a9730c35aae11c880217c2e5b3ca23fc31b271f4a7f3</citedby><cites>FETCH-LOGICAL-c375t-ea2cfafda6f59e50c2733a9730c35aae11c880217c2e5b3ca23fc31b271f4a7f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00383-019-04577-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00383-019-04577-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31555863$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Murakami, Hiroshi</creatorcontrib><creatorcontrib>Koga, Hiroyuki</creatorcontrib><creatorcontrib>Lane, Geoffrey</creatorcontrib><creatorcontrib>Hirayama, Shunki</creatorcontrib><creatorcontrib>Suzuki, Kenji</creatorcontrib><creatorcontrib>Yamataka, Atsuyuki</creatorcontrib><title>Does fissure status affect the outcome of thoracoscopic pulmonary lobectomy?</title><title>Pediatric surgery international</title><addtitle>Pediatr Surg Int</addtitle><addtitle>Pediatr Surg Int</addtitle><description>Purpose We studied fissure status and devices used to divide lung parenchyma during thoracoscopic pulmonary lobectomy (TPL). Methods 52 consecutive TPL indicated for congenital pulmonary airway malformation or interlobar pulmonary sequestration performed between 2009 and 2019 were reviewed prospectively to compare patients with absent fissure and no visible interlobar pulmonary artery (IPA) treated by stapling (group A; n  = 10), incomplete fissure with partially visible IPA treated with an Enseal ® or LigaSure™ device (group I; n  = 17), and complete fissure with fully visible IPA treated by electrocautery (group C; n  = 25). Results Patient demographics were similar. Mean age at TPL was 2.82 years (range 0.03–9.81). Mean duration of follow-up was 4.77 years (range 0.33–10.19). Operative time and duration of chest tube insertion were similar ( p  = NS). Intraoperative blood loss was significantly lower in group C compared with group I ( p  = 0.028). Complications were minor bronchial artery hemorrhage during anterior-to-posterior bronchial dissection (group A: n  = 1; group I: n  = 1), problematic single lung ventilation (group I: n  = 1), and persistent postoperative air leak (group I: n  = 1). 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Methods 52 consecutive TPL indicated for congenital pulmonary airway malformation or interlobar pulmonary sequestration performed between 2009 and 2019 were reviewed prospectively to compare patients with absent fissure and no visible interlobar pulmonary artery (IPA) treated by stapling (group A; n  = 10), incomplete fissure with partially visible IPA treated with an Enseal ® or LigaSure™ device (group I; n  = 17), and complete fissure with fully visible IPA treated by electrocautery (group C; n  = 25). Results Patient demographics were similar. Mean age at TPL was 2.82 years (range 0.03–9.81). Mean duration of follow-up was 4.77 years (range 0.33–10.19). Operative time and duration of chest tube insertion were similar ( p  = NS). Intraoperative blood loss was significantly lower in group C compared with group I ( p  = 0.028). Complications were minor bronchial artery hemorrhage during anterior-to-posterior bronchial dissection (group A: n  = 1; group I: n  = 1), problematic single lung ventilation (group I: n  = 1), and persistent postoperative air leak (group I: n  = 1). Conclusion While fissure status does not appear to affect the outcome of TPL in children, the choice of device for dividing lung parenchyma relies specifically on fissure status.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>31555863</pmid><doi>10.1007/s00383-019-04577-z</doi><tpages>5</tpages></addata></record>
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subjects Blood Loss, Surgical
Child
Child, Preschool
Dissection
Electrocoagulation
Female
Hemostasis, Surgical - instrumentation
Hospital costs
Humans
Infant
Infant, Newborn
Lung - pathology
Lung - surgery
Male
Medicine
Medicine & Public Health
Original Article
Patients
Pediatric Surgery
Pediatrics
Pneumonectomy - methods
Postoperative Complications
Prospective Studies
Pulmonary arteries
Surgery
Surgical Stapling
Thoracic surgery
Thoracoscopy
Veins & arteries
Ventilators
title Does fissure status affect the outcome of thoracoscopic pulmonary lobectomy?
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