Harmonic scalpel in thoracoscopic surgery for lung cancer: A case control study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

SHI Yan , WANG Luming , WANG Yiqing , LV Wang ,  HU Jian

Department of Thoracic Surgery, the First Affiliated Hospital, Zhejiang University, Hangzhou, 310003, P.R.China;

Corresponding?author：

HU Jian, Email: dr_hujian@zju.edu.cn

Keywords：

Harmonic scalpel; thoracoscopic surgery; pulmonary wedge resection; pulmonary lobectomy

DOI：

10.7507/1007-4848.201711041

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the clinical effects of harmonic scalpel application in thoracoscopic surgery for lung cancer, which may guide its reasonable application. Methods We retrospectively analyzed the clinical data of 145 lung cancer patients receiving thoracoscopic surgery from January to March 2017 in our hospital. There were 57 patients with thoracoscopic pulmonary wedge resection, and harmonic scalpel was used in 34 patients (8 males, 26 females at age of 59.68±10.91 years), and was not used in 23 patients (13 males and 10 females at age of 59.13±11.21 years). There were 88 patients receiving thoracoscopic pulmonary lobectomy, among whom harmonic scalpel was used in 80 patients (36 males and 44 females at age of 59.68±10.91 years), and was not used in 8 patients (5 males, 3 females at age of 61.63±5.60 years). We recorded the perioperative outcomes of all patients. Results In the 34 patients undergoing thoracoscopic pulmonary wedge resection by harmonic scalpe, the operation time was 90.09±43.52 min, the blood loss was 21.32±12.75 ml, the number of lymph nodes resected was 5.12±4.26, duration of drainage was 3.15±1.16 d, volume of drainage was 535.00±291.69 ml, the length of postoperative hospital stay was 4.56±1.40 d, and no postoperative complication was observed. In the 80 patients receiving thoracoscopic pulmonary lobectomy by harmonic scalpel, operation time was 131.88±41.82 min, blood loss was 42.79±31.62 ml, the number of lymph nodes resected was 13.54±8.75, duration of thoracic drainage was 4.47±2.30 d, drainage volume was 872.09±585.24 ml, the length of postoperative hospital stay was 5.81±2.26 d, and 20 patients had postoperative complications. No complication occurred in the 8 patients without harmonic scalpel. Conclusion Harmonic scalpel showed satisfactory effectiveness and safety in lung cancer thoracoscopic surgery.

Citation： SHI Yan, WANG Luming, WANG Yiqing, LV Wang, HU Jian. Harmonic scalpel in thoracoscopic surgery for lung cancer: A case control study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(1): 17-22. doi: 10.7507/1007-4848.201711041 Copy

1.	Chen WQ, Zheng RS, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
2.	Yan TD, Black D, Bannon PG, et al. Systematic review and meta-analysis of randomized and nonrandomized trials on safety and efficacy of video-assisted thoracic surgery lobectomy for early-stage non-small-cell lung cancer. J Clin Oncol, 2009, 27(15): 2553-2562.
3.	D’Amico TA, Niland J, Mamet R, et al. Efficacy of mediastinal lymph node dissection during lobectomy for lung cancer by thoracoscopy and thoracotomy. Ann Thorac Surg, 2011, 92(1): 226-231.
4.	Sutton C, Abbott J. History of power sources in endoscopic Surgery. J Minim Invasive Gynecol, 2013, 20(3): 271-278.
5.	王璐, 朱珉. 超聲刀與電刀在胸外科手術中的應用與比較. 醫學綜述, 2015(11): 1997-1999.
6.	Dobrogowski M, Wesolowski W, Kurcharska M, et al. Chemical composition of surgical smoke formed in the abdominal cavity during laparoscopic cholecystectomy-assessment of the risk to the patient. Int J Occup Med Environ Health, 2014, 27(2): 314-325.
7.	李傳行, 王存川, 徐國良, 等. 腹腔鏡手術超聲止血刀與電刀封合血管的對比實驗研究. 中國內鏡雜志, 2001, 7(6): 42-43.
8.	代明盛, 吳志明, 婁建平, 等. 超聲刀聯合高頻電刀在腹腔鏡膽囊切除術中的應用. 實用醫學雜志, 2007, 21(20): 2282-2283.
9.	中國醫師協會胸外科醫師分會微創外科專家委員會, 劉倫旭, 李印, 胡堅, 等. 胸腔鏡手術超聲刀規范使用專家共識(2017 版). 中國胸心血管外科臨床雜志, 2017, 24(6): 407-412.
10.	Verazin GT, Regal AM, Antkowiak JG, et al. Ultrasonic surgical aspirator for lung resection. Ann Thorac Surg, 1991, 52(4): 787-790.
11.	Yamada S, Yoshino K, Inoue H. New-model ultrasonically activated shears for hemostatic sectioning during video-assisted thoracic surgery. Gen Thorac Cardiovasc Surg, 2007, 55(12): 518-520.
12.	Takagi K, Hata Y, Sasamoto S, et al. Late onset postoperative pulmonary fistula following a pulmonary segmentectomy using electrocautery or a harmonic scalpel. Ann Thorac Cardiovasc, 2010, 16(1): 21-25.
13.	Tanaka K, Hagiwara M, Kondo Y, et al. Usefulness of ultrasonically activated scalpel for pulmonary resection in video-assisted thoracoscopic surgery. Kyobu Geka, 2006, 59(13): 1171-1175.
14.	Peng J, Chen XL, Mao X, et al. Video-assisted thoracoscopic right lower lobectomy for lung cancer using the harmonic scalpel. J Thorac Dis, 2013, 5(6): 864-867.
15.	聶廣杰, 吳祖培, 葉偉紅, 等. 超聲刀在胸腔鏡輔助早期肺癌手術中的應用價值. 實用醫學雜志, 2011, 27(14): 2568-2570.
16.	Lee BI. Indications of knives and electric current: what’s the best? Clin Endosc, 2012, 45(3): 285-287.

1. Chen WQ, Zheng RS, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
2. Yan TD, Black D, Bannon PG, et al. Systematic review and meta-analysis of randomized and nonrandomized trials on safety and efficacy of video-assisted thoracic surgery lobectomy for early-stage non-small-cell lung cancer. J Clin Oncol, 2009, 27(15): 2553-2562.
3. D’Amico TA, Niland J, Mamet R, et al. Efficacy of mediastinal lymph node dissection during lobectomy for lung cancer by thoracoscopy and thoracotomy. Ann Thorac Surg, 2011, 92(1): 226-231.
4. Sutton C, Abbott J. History of power sources in endoscopic Surgery. J Minim Invasive Gynecol, 2013, 20(3): 271-278.
5. 王璐, 朱珉. 超聲刀與電刀在胸外科手術中的應用與比較. 醫學綜述, 2015(11): 1997-1999.
6. Dobrogowski M, Wesolowski W, Kurcharska M, et al. Chemical composition of surgical smoke formed in the abdominal cavity during laparoscopic cholecystectomy-assessment of the risk to the patient. Int J Occup Med Environ Health, 2014, 27(2): 314-325.
7. 李傳行, 王存川, 徐國良, 等. 腹腔鏡手術超聲止血刀與電刀封合血管的對比實驗研究. 中國內鏡雜志, 2001, 7(6): 42-43.
8. 代明盛, 吳志明, 婁建平, 等. 超聲刀聯合高頻電刀在腹腔鏡膽囊切除術中的應用. 實用醫學雜志, 2007, 21(20): 2282-2283.
9. 中國醫師協會胸外科醫師分會微創外科專家委員會, 劉倫旭, 李印, 胡堅, 等. 胸腔鏡手術超聲刀規范使用專家共識(2017 版). 中國胸心血管外科臨床雜志, 2017, 24(6): 407-412.
10. Verazin GT, Regal AM, Antkowiak JG, et al. Ultrasonic surgical aspirator for lung resection. Ann Thorac Surg, 1991, 52(4): 787-790.
11. Yamada S, Yoshino K, Inoue H. New-model ultrasonically activated shears for hemostatic sectioning during video-assisted thoracic surgery. Gen Thorac Cardiovasc Surg, 2007, 55(12): 518-520.
12. Takagi K, Hata Y, Sasamoto S, et al. Late onset postoperative pulmonary fistula following a pulmonary segmentectomy using electrocautery or a harmonic scalpel. Ann Thorac Cardiovasc, 2010, 16(1): 21-25.
13. Tanaka K, Hagiwara M, Kondo Y, et al. Usefulness of ultrasonically activated scalpel for pulmonary resection in video-assisted thoracoscopic surgery. Kyobu Geka, 2006, 59(13): 1171-1175.
14. Peng J, Chen XL, Mao X, et al. Video-assisted thoracoscopic right lower lobectomy for lung cancer using the harmonic scalpel. J Thorac Dis, 2013, 5(6): 864-867.
15. 聶廣杰, 吳祖培, 葉偉紅, 等. 超聲刀在胸腔鏡輔助早期肺癌手術中的應用價值. 實用醫學雜志, 2011, 27(14): 2568-2570.
16. Lee BI. Indications of knives and electric current: what’s the best? Clin Endosc, 2012, 45(3): 285-287.

Previous Article
股腘動脈閉塞病變減容治療進展
Next Article
股腘動脈閉塞病變減容治療進展

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Harmonic scalpel in thoracoscopic surgery for lung cancer: A case control study

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content