title: Comparison of the value of tissue-sealing devices for thoracoscopic pulmonary lobectomy in small children: a first report.
abstract: Accurate division and sealing of lung parenchyma particularly in cases of total or near total incomplete fissure are crucial for preventing air leakage following thoracoscopic pulmonary lobectomy (TPL). However, conventional endoscopic stapling devices cannot be used during TPL in small children because of limited space. Consequently, Ligasure (LS) and Enseal (ES) devices are being used instead. We are the first to compare LS and ES for efficacy and efficiency during TPL. Of 26 TPL (6 upper, 3 middle, and 17 lower) performed for congenital adenomatoid malformation (n = 16) and sequestration (n = 10), incomplete fissure was found in 14. TPL (LS = 11; ES = 15) was performed conventionally in the lateral decubitus position with single lung ventilation using four 5 mm trocars. All cases had a chest tube inserted intraoperatively that was left in situ. Patient demographics, location of pathology, incidence of incomplete fissure, mean age/weight at TPL, mean blood loss, and mean operative time were all similar. However, duration of chest tube insertion was significantly shorter in ES because there was less postoperative air leakage (1.3 vs. 3.9 days; p < 0.05). ES would appear to seal lung parenchyma more effectively during TPL based on the shorter duration of chest tube insertion.
authors: Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, 113-8421, Japan, h-koga@juntendo.ac.jp.
authors: Hiroyuki
authors: H
authors: Koga
authors: Kenji
authors: K
authors: Suzuki
authors: Kinya
authors: K
authors: Nishimura
authors: Manabu
authors: M
authors: Okawada
authors: Takashi
authors: T
authors: Doi
authors: Geoffrey J
authors: GJ
authors: Lane
authors: Eiichi
authors: E
authors: Inada
authors: Tadaharu
authors: T
authors: Okazaki
authors: Atsuyuki
authors: A
authors: Yamataka
mesh_terms: D001998:Bronchopulmonary Sequestration / Q000601:surgery*; D002675:Child, Preschool; D015615:Cystic Adenomatoid Malformation of Lung, Congenital / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D008168:Lung / Q000601:surgery*; D008297:Male; D011013:Pneumonectomy / Q000379:methods*; D017792:Surgical Stapling / Q000295:instrumentation* / Q000379:methods; D013906:Thoracoscopy / Q000379:methods*; D016896:Treatment Outcome