Application of microwave surgical instrument to lung segmentectomy for small-sized lung cancerCentral MessagePerspective

Objectives: For lung segmentectomy of small lung cancers, we used a microwave surgical instrument for lung parenchymal dissection mainly at the pulmonary hilum, which is difficult to handle with surgical staplers. This technique facilitated the insertion of staples. Methods: In total, 116 patients w...

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Main Authors: Takeshi Mimura, MD, PhD, Masayuki Ishida, MD, Kazuki Tadokoro, MD, Atsushi Kamigaichi, MD, Yuya Hirai, MD, Mai Nishina, MD, Atsushi Kagimoto, MD, PhD, Norifumi Tsubokawa, MD, PhD, Yoshinori Yamashita, MD, PhD
Format: Article
Language:English
Published: Elsevier 2024-04-01
Series:JTCVS Techniques
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666250724000579
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author Takeshi Mimura, MD, PhD
Masayuki Ishida, MD
Kazuki Tadokoro, MD
Atsushi Kamigaichi, MD
Yuya Hirai, MD
Mai Nishina, MD
Atsushi Kagimoto, MD, PhD
Norifumi Tsubokawa, MD, PhD
Yoshinori Yamashita, MD, PhD
author_facet Takeshi Mimura, MD, PhD
Masayuki Ishida, MD
Kazuki Tadokoro, MD
Atsushi Kamigaichi, MD
Yuya Hirai, MD
Mai Nishina, MD
Atsushi Kagimoto, MD, PhD
Norifumi Tsubokawa, MD, PhD
Yoshinori Yamashita, MD, PhD
author_sort Takeshi Mimura, MD, PhD
collection DOAJ
description Objectives: For lung segmentectomy of small lung cancers, we used a microwave surgical instrument for lung parenchymal dissection mainly at the pulmonary hilum, which is difficult to handle with surgical staplers. This technique facilitated the insertion of staples. Methods: In total, 116 patients with cStage 0-1A3 non–small cell lung cancer who underwent lung segmentectomy were included in this study. We compared the perioperative factors of the group in which a microwave surgical instrument was used for dissection procedures, including lung parenchymal dissection at the pulmonary hilum, and peripheral intersegmental dissection was performed with surgical staplers (group M+S: N = 69), with those of the group in which parenchymal dissection was performed mainly with surgical staplers without using the microwave surgical instrument (group S: N = 47). Results: Although more complex segmentectomies were performed in the M+S group (P = .001), the number of staple cartridges (7 staple cartridges vs 8 staple cartridges, P = .005), the surgical times (179 vs 221 minutes, P < .0001), and the blood loss (5 mL vs 30 mL, P = .012) were significantly lower in the M+S group. The duration of chest tube placement was significantly shorter in the M+S group (P = .019), and postoperative complications of grade 2 or greater were significantly lower in the M+S group (P = .049). Conclusions: The effective use of the microwave surgical instrument combined with surgical staplers can simplify pulmonary hilar and intersegmental plane dissections not only for simple segmentectomy but also for complex segmentectomy, leading to favorable intraoperative and postoperative outcomes.
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spelling doaj-art-5dce32effa2e4d6e95b10c7ad90d8c9a2025-08-20T03:38:26ZengElsevierJTCVS Techniques2666-25072024-04-012418619610.1016/j.xjtc.2024.02.002Application of microwave surgical instrument to lung segmentectomy for small-sized lung cancerCentral MessagePerspectiveTakeshi Mimura, MD, PhD0Masayuki Ishida, MD1Kazuki Tadokoro, MD2Atsushi Kamigaichi, MD3Yuya Hirai, MD4Mai Nishina, MD5Atsushi Kagimoto, MD, PhD6Norifumi Tsubokawa, MD, PhD7Yoshinori Yamashita, MD, PhD8Address for reprints: Takeshi Mimura, MD, PhD, Department of General Thoracic Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, 3-1, Aoyama-cho, Kure, Hiroshima 737-0023, Japan.; Department of General Thoracic Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan, Kure, Hiroshima, JapanDepartment of General Thoracic Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan, Kure, Hiroshima, JapanDepartment of General Thoracic Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan, Kure, Hiroshima, JapanDepartment of General Thoracic Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan, Kure, Hiroshima, JapanDepartment of General Thoracic Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan, Kure, Hiroshima, JapanDepartment of General Thoracic Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan, Kure, Hiroshima, JapanDepartment of General Thoracic Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan, Kure, Hiroshima, JapanDepartment of General Thoracic Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan, Kure, Hiroshima, JapanDepartment of General Thoracic Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan, Kure, Hiroshima, JapanObjectives: For lung segmentectomy of small lung cancers, we used a microwave surgical instrument for lung parenchymal dissection mainly at the pulmonary hilum, which is difficult to handle with surgical staplers. This technique facilitated the insertion of staples. Methods: In total, 116 patients with cStage 0-1A3 non–small cell lung cancer who underwent lung segmentectomy were included in this study. We compared the perioperative factors of the group in which a microwave surgical instrument was used for dissection procedures, including lung parenchymal dissection at the pulmonary hilum, and peripheral intersegmental dissection was performed with surgical staplers (group M+S: N = 69), with those of the group in which parenchymal dissection was performed mainly with surgical staplers without using the microwave surgical instrument (group S: N = 47). Results: Although more complex segmentectomies were performed in the M+S group (P = .001), the number of staple cartridges (7 staple cartridges vs 8 staple cartridges, P = .005), the surgical times (179 vs 221 minutes, P < .0001), and the blood loss (5 mL vs 30 mL, P = .012) were significantly lower in the M+S group. The duration of chest tube placement was significantly shorter in the M+S group (P = .019), and postoperative complications of grade 2 or greater were significantly lower in the M+S group (P = .049). Conclusions: The effective use of the microwave surgical instrument combined with surgical staplers can simplify pulmonary hilar and intersegmental plane dissections not only for simple segmentectomy but also for complex segmentectomy, leading to favorable intraoperative and postoperative outcomes.http://www.sciencedirect.com/science/article/pii/S2666250724000579lung segmentectomymicrowave surgical instrumentnon–small cell lung cancersurgical stapler
spellingShingle Takeshi Mimura, MD, PhD
Masayuki Ishida, MD
Kazuki Tadokoro, MD
Atsushi Kamigaichi, MD
Yuya Hirai, MD
Mai Nishina, MD
Atsushi Kagimoto, MD, PhD
Norifumi Tsubokawa, MD, PhD
Yoshinori Yamashita, MD, PhD
Application of microwave surgical instrument to lung segmentectomy for small-sized lung cancerCentral MessagePerspective
JTCVS Techniques
lung segmentectomy
microwave surgical instrument
non–small cell lung cancer
surgical stapler
title Application of microwave surgical instrument to lung segmentectomy for small-sized lung cancerCentral MessagePerspective
title_full Application of microwave surgical instrument to lung segmentectomy for small-sized lung cancerCentral MessagePerspective
title_fullStr Application of microwave surgical instrument to lung segmentectomy for small-sized lung cancerCentral MessagePerspective
title_full_unstemmed Application of microwave surgical instrument to lung segmentectomy for small-sized lung cancerCentral MessagePerspective
title_short Application of microwave surgical instrument to lung segmentectomy for small-sized lung cancerCentral MessagePerspective
title_sort application of microwave surgical instrument to lung segmentectomy for small sized lung cancercentral messageperspective
topic lung segmentectomy
microwave surgical instrument
non–small cell lung cancer
surgical stapler
url http://www.sciencedirect.com/science/article/pii/S2666250724000579
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