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：

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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. 超声刀与电刀在胸外科手术中的应用与比较. 医学综述, 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.	李传行, 王存川, 徐国良, 等. 腹腔镜手术超声止血刀与电刀封合血管的对比实验研究. 中国内镜杂志, 2001, 7(6): 42-43.
8.	代明盛, 吴志明, 娄建平, 等. 超声刀联合高频电刀在腹腔镜胆囊切除术中的应用. 实用医学杂志, 2007, 21(20): 2282-2283.
9.	中国医师协会胸外科医师分会微创外科专家委员会, 刘伦旭, 李印, 胡坚, 等. 胸腔镜手术超声刀规范使用专家共识(2017 版). 中国胸心血管外科临床杂志, 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.	聂广杰, 吴祖培, 叶伟红, 等. 超声刀在胸腔镜辅助早期肺癌手术中的应用价值. 实用医学杂志, 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. 超声刀与电刀在胸外科手术中的应用与比较. 医学综述, 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. 李传行, 王存川, 徐国良, 等. 腹腔镜手术超声止血刀与电刀封合血管的对比实验研究. 中国内镜杂志, 2001, 7(6): 42-43.
8. 代明盛, 吴志明, 娄建平, 等. 超声刀联合高频电刀在腹腔镜胆囊切除术中的应用. 实用医学杂志, 2007, 21(20): 2282-2283.
9. 中国医师协会胸外科医师分会微创外科专家委员会, 刘伦旭, 李印, 胡坚, 等. 胸腔镜手术超声刀规范使用专家共识(2017 版). 中国胸心血管外科临床杂志, 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. 聂广杰, 吴祖培, 叶伟红, 等. 超声刀在胸腔镜辅助早期肺癌手术中的应用价值. 实用医学杂志, 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.

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

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