The benefits of stapler tractor dissociating segmental bronchus in lung segmentectomy:A retrospective cohort study in a single center
Objective To investigate the benefits of using a stapler tractor in the treatment of segmental bronchus during lung segmentectomy through detailed video replay analysis of surgical procedures.Methods We collected data from patients who underwent segmentectomy performed by the same surgical team in the Department of Thoracic Surgery,the First Affiliated Hospital of Nanjing Medical University,from November 2020 to August 2023.After excluding data that lacked analysis parameters,the remaining patients were divided into four groups based on the methods used for dissociating segmental bronchus:a stapler tractor group(group A),a stapler with bronchial stretching group(group B),a stapler only group(group C),and a silk ligature group(group D).Then,we compared baseline data and videotaped surgical details across all groups.Surgical details included the success rate of one-time segmental bronchus dissociation and severance,the time taken for successful one-time dissociation and severance of the segmental bronchus,the incidence of bleeding during bronchus dissociation,the conversion rate to thoracotomy during surgery,and surgical outcomes such as total operative time,postoperative hospitalization days,postoperative thoracic drainage volume,and pulmonary air leakage rate.Results The study included 325 patients(203 in the group A,62 in the group B,29 in the group C,and 31 in the group D).There was no statistically significant difference in baseline data among the four groups.However,significant differences were found in terms of total operation time,postoperative hospitalization days,intraoperative blood loss,segmental bronchial stump length,postoperative air leakage rate,hemorrhage rate during segmental bronchial dissociation,and conversion to thoracotomy rate among the four groups(P＜0.05).Conclusion Using a stapler tractor for dissociating segmental bronchus in lung segmentectomy results in shorter operative time,less risk of intraoperative bleeding,and less surgical complications.This study provides valuable evaluation methodologies through the analysis of video replay surgical details,contributing to the improvement of lung segmentectomy quality.
Lung segmentectomysurgical techniquestapler tractorflat tube tractorsurgical quality evaluationsurgical video replay
张斌、郑佳男、陈亮、朱全、朱健、闻伟
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江苏大学附属句容医院胸外科(江苏镇江 242400)
南京医科大学第一附属医院(江苏省人民医院)胸外科(南京 210029)
中国人民解放军中部战区总医院心胸外科(武汉 430070)
肺段切除手术 手术技巧 直线切割缝合器 扁管型引导装置 手术质量评价 手术录像回放
国家自然科学基金面上项目中国人民解放军中部战区总医院"三英一队"人才工程项目(2023-1692)The"Three Heroes and One Team"Talent Project of the Central Theater Command General Hospital of the People's Liberation Army of
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