Application of Silk Ligation for Pulmonary Artery in Video-assisted Thoracoscopic Lobectomy_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

CHENJian ,  LIUJian , ZHANBi-cheng , LIUYong-zhi , WANGHuan

Department of Cardiothoracic Surgery, Anqing Municipal Hospital, Anhui Medical University, Anqing 246003 Anhui, P. R. China;

Corresponding?author：

LIUJian, Email: Lj-zhenjiang@yahoo.com.cn

Keywords：

Pulmonary artery; Ligation; Video-assisted thoracic surgery; Lobectomy

DOI：

10.7507/1007-4848.20160108

Video：

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Objective To investigate the security and feasibility of silk ligating for pulmonary artery in video-assisted thoracoscopic lobectomy, and to summarize the clinical skills. Methods We retrospectively analyzed the clinical data of 68 patients underwent the video-assisted thoracoscopic lobectomy from April 2013 to March 2015. There were 49 males and 19 females with the mean age of 59.6±10.3 years, ranging from 38 to 76 years. We divided the patients into an ECR60W cut-up group (31 patients) and a silk ligation group (37 patients). There were 22 males and 9 females patients with the average age of 59.3±9.9 years with ECR60W. There were 27 males and 10 females patients with the average age of 59.9±10.5 years with silk ligation. We observed the effect of hemostasis, and analyzed the amount of bleeding loss during operation, postoperative suction drainage and the cost of operation material between the two groups. Results There were 4 patients out of 68 converted to the open lobectomy, and all of them used ECR60W. The application of silk ligation for pulmo-nary artery could effectively control bleeding loss and avoid massive amount of bleeding due to the vascular tear in opera-tions. Furthermore, the application can reduce the rate of severe complications such as massive bleeding resulting from postoperative silk ligation slippage. There was a statistical difference between the two groups on the cost of operation mate-rials (P < 0.01). Conclusions Silk ligation for pulmonary artery in video-assisted thoracoscopic lobectomy is simple and prac-tical to apply. Compared with the ECR60W, it can significantly reduce the cost of operation material. It's worth to popularize in clinic.

Citation： CHENJian, LIUJian, ZHANBi-cheng, LIUYong-zhi, WANGHuan. Application of Silk Ligation for Pulmonary Artery in Video-assisted Thoracoscopic Lobectomy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(5): 459-462. doi: 10.7507/1007-4848.20160108 Copy

1.	陳海兵, 朱全, 陳亮. 連續231例全電視胸腔鏡肺葉切除術治療非小細胞肺癌近、遠期療效分析. 中國胸心血管外科臨床雜志, 2013, 20(6):673-678.
2.	劉倫旭. 開胸手術將逐漸"升級"為胸腔鏡微創手術的補充. 中國胸心血管外科臨床雜志, 2012, 19(2):109-112.
3.	黃佳, 趙曉菁, 林皓, 等. 單向四孔法全胸腔鏡肺葉切除術治療非小細胞肺癌的臨床研究. 中國胸心血管外科臨床雜志, 2012, 9(2):125-129.
4.	田界勇, 馬冬春, 徐美清, 等. 全胸腔鏡肺葉切除術治療周圍型肺癌的臨床分析. 中國胸心血管外科臨床雜志, 2012, 19(5):479-483.
5.	Wang BY, Tu CC, Liu CY, et al. Single-incision thoracoscopic lobectomy and segmentectomy with radical lymph node dissection. Ann Thorac Surg, 2013, 96(3):977-982.
6.	Zhou ZL, Zhao H, Li Y. Completely thoracoscopic lobectomy for the surgical management of bronchiectasis. Chin Med J, 2013, 126(5):875-878.
7.	羅東, 尹杰, 柯有力. 電視胸腔鏡肺葉切除術治療早期非小細胞肺癌臨床分析. 微創醫學, 2015, 10(1):22-24.
8.	林宗武, 徐松濤, 王群. 半俯臥位單孔胸腔鏡肺葉切除術的初步探討. 中國臨床醫學, 2015, 22(2):159-164.
9.	Stephens N, Rice D, Correa A, et al. Thoracoscopic lobectomy is associated with improved short-term and equivalent oncological outcomes compared with open lobectomy for clinical stage I non-small-cell lung cancer, a propensity-matched analysis of 963 cases. Eur J Cardiothorac Surg, 2014, 46(4):607-620.
10.	Klapper J, D'Amico TA. VATS versus open surgery for lung cancer resection:Moving toward a minimally invasive approach. J Natl Compr Canc Netw, 2015, 13(2):162-164.
11.	Nwogu CE, D'Cunha J, Pang H. VATS lobectomy has better perioperative outcomes than open lobectomy:CALGB 31001,An ancillary analysis of CALGB 140202(Alliance).Ann Thorac Surg, 2015, 99(2):399-404.
12.	Linden PA, Nwogu CE, Reyna R. VATS lobectomy has better perioperative outcomes than open lobectomy:CALGB 31001, An ancillary analysis of CALGB 140202(Alliance). Ann Thorac Surg, 2015, 99(2):404-405.
13.	蔣偉, 奚俊杰, 汪灝, 等. 全胸腔鏡肺葉切除術治療臨床早期非小細胞肺癌的療效評價. 中國胸心血管外科臨床雜志, 2012, 19(2):120-124.
14.	王強, 吳勇, 徐文舉, 等. 非昂貴耗材的完全胸腔鏡手工肺葉切除術. 中國微創外科雜志, 2012, 12(11):966-968.
15.	劉倫旭, 劉成武, 楊俊杰. 胸腔鏡肺葉切除術:技術優化與應用拓展. 四川大學學報(醫學版), 2013, 44(1):104-108.
16.	李運, 楊帆, 趙輝, 等. 全胸腔鏡肺葉切除術中轉開胸的淋巴結影響. 中華胸心血管外科雜志, 2013, 29(10):591-594.
17.	Lee HS, Jang HJ. Thoracoscopic mediastinal lymph node dissection for lung cancer. Semin Thorac Cardiovasc Surg, 2012, 24:131-141.
18.	Nakamura Y, Iwazaki M, Watanabe R, et al. Pulmonary inflam-matory pseudotumor observed by bronchoscopy and resected using video-assisted thoracic surgery. Gen Thorac Cardiovasc Surg, 2013, 61(4):234-237.
19.	Samson P,Guitron J,Reed MF,et al. Predictors of conversion to Thoracotomy for video-assisted thoracoscopic lobectomy:a retrospective analysis and the influence of computed tomography-based caleification assessment. J Thorac Cardiovasc Surg, 2013, 145(6):1512-1518.
20.	周逸鳴, 姜格寧, 朱余明, 等. 單中心連續2000例全胸腔鏡肺葉切除中轉開胸分析.中華胸心血管外科雜志, 2013, 29(8):477-479.
21.	Okamoto J, Kubokura H, Usuda J. Safe transection of aberrant arteries associated with pulmonary sequestrations. BMC Surg, 2015, 15(1):9.
22.	Nakanishi R, Yamashita T, Oka S. Initial experience of video-assisted thoracic surgery lobectomy with partial removal of the pulmonary artery. Interact Cardiovasc Thorac surg, 2008, 7(6):996-1000.
23.	李運, 楊帆, 劉彥國, 等. 全胸腔鏡肺葉切除術中轉開胸手術指征的探討. 中國胸心血管外科臨床雜志, 2010, 17(1):32-35.
24.	Nosotti M, Cioffi U, De Simone M, et al. Systematic mediastinal nodal dissection and video-assisted thoracic surgery. Eur J Cardio-thorac Surg, 2012, 42(2):385-386.

1. 陳海兵, 朱全, 陳亮. 連續231例全電視胸腔鏡肺葉切除術治療非小細胞肺癌近、遠期療效分析. 中國胸心血管外科臨床雜志, 2013, 20(6):673-678.
2. 劉倫旭. 開胸手術將逐漸"升級"為胸腔鏡微創手術的補充. 中國胸心血管外科臨床雜志, 2012, 19(2):109-112.
3. 黃佳, 趙曉菁, 林皓, 等. 單向四孔法全胸腔鏡肺葉切除術治療非小細胞肺癌的臨床研究. 中國胸心血管外科臨床雜志, 2012, 9(2):125-129.
4. 田界勇, 馬冬春, 徐美清, 等. 全胸腔鏡肺葉切除術治療周圍型肺癌的臨床分析. 中國胸心血管外科臨床雜志, 2012, 19(5):479-483.
5. Wang BY, Tu CC, Liu CY, et al. Single-incision thoracoscopic lobectomy and segmentectomy with radical lymph node dissection. Ann Thorac Surg, 2013, 96(3):977-982.
6. Zhou ZL, Zhao H, Li Y. Completely thoracoscopic lobectomy for the surgical management of bronchiectasis. Chin Med J, 2013, 126(5):875-878.
7. 羅東, 尹杰, 柯有力. 電視胸腔鏡肺葉切除術治療早期非小細胞肺癌臨床分析. 微創醫學, 2015, 10(1):22-24.
8. 林宗武, 徐松濤, 王群. 半俯臥位單孔胸腔鏡肺葉切除術的初步探討. 中國臨床醫學, 2015, 22(2):159-164.
9. Stephens N, Rice D, Correa A, et al. Thoracoscopic lobectomy is associated with improved short-term and equivalent oncological outcomes compared with open lobectomy for clinical stage I non-small-cell lung cancer, a propensity-matched analysis of 963 cases. Eur J Cardiothorac Surg, 2014, 46(4):607-620.
10. Klapper J, D'Amico TA. VATS versus open surgery for lung cancer resection:Moving toward a minimally invasive approach. J Natl Compr Canc Netw, 2015, 13(2):162-164.
11. Nwogu CE, D'Cunha J, Pang H. VATS lobectomy has better perioperative outcomes than open lobectomy:CALGB 31001,An ancillary analysis of CALGB 140202(Alliance).Ann Thorac Surg, 2015, 99(2):399-404.
12. Linden PA, Nwogu CE, Reyna R. VATS lobectomy has better perioperative outcomes than open lobectomy:CALGB 31001, An ancillary analysis of CALGB 140202(Alliance). Ann Thorac Surg, 2015, 99(2):404-405.
13. 蔣偉, 奚俊杰, 汪灝, 等. 全胸腔鏡肺葉切除術治療臨床早期非小細胞肺癌的療效評價. 中國胸心血管外科臨床雜志, 2012, 19(2):120-124.
14. 王強, 吳勇, 徐文舉, 等. 非昂貴耗材的完全胸腔鏡手工肺葉切除術. 中國微創外科雜志, 2012, 12(11):966-968.
15. 劉倫旭, 劉成武, 楊俊杰. 胸腔鏡肺葉切除術:技術優化與應用拓展. 四川大學學報(醫學版), 2013, 44(1):104-108.
16. 李運, 楊帆, 趙輝, 等. 全胸腔鏡肺葉切除術中轉開胸的淋巴結影響. 中華胸心血管外科雜志, 2013, 29(10):591-594.
17. Lee HS, Jang HJ. Thoracoscopic mediastinal lymph node dissection for lung cancer. Semin Thorac Cardiovasc Surg, 2012, 24:131-141.
18. Nakamura Y, Iwazaki M, Watanabe R, et al. Pulmonary inflam-matory pseudotumor observed by bronchoscopy and resected using video-assisted thoracic surgery. Gen Thorac Cardiovasc Surg, 2013, 61(4):234-237.
19. Samson P,Guitron J,Reed MF,et al. Predictors of conversion to Thoracotomy for video-assisted thoracoscopic lobectomy:a retrospective analysis and the influence of computed tomography-based caleification assessment. J Thorac Cardiovasc Surg, 2013, 145(6):1512-1518.
20. 周逸鳴, 姜格寧, 朱余明, 等. 單中心連續2000例全胸腔鏡肺葉切除中轉開胸分析.中華胸心血管外科雜志, 2013, 29(8):477-479.
21. Okamoto J, Kubokura H, Usuda J. Safe transection of aberrant arteries associated with pulmonary sequestrations. BMC Surg, 2015, 15(1):9.
22. Nakanishi R, Yamashita T, Oka S. Initial experience of video-assisted thoracic surgery lobectomy with partial removal of the pulmonary artery. Interact Cardiovasc Thorac surg, 2008, 7(6):996-1000.
23. 李運, 楊帆, 劉彥國, 等. 全胸腔鏡肺葉切除術中轉開胸手術指征的探討. 中國胸心血管外科臨床雜志, 2010, 17(1):32-35.
24. Nosotti M, Cioffi U, De Simone M, et al. Systematic mediastinal nodal dissection and video-assisted thoracic surgery. Eur J Cardio-thorac Surg, 2012, 42(2):385-386.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Application of Silk Ligation for Pulmonary Artery in Video-assisted Thoracoscopic Lobectomy

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