A Retrospective Comparative Study of 2-μm Thulium Laser During Thoracoscopic Resection of Pulmonary Nodules

Abstract

This study aimed to evaluate the feasibility and safety of a 2-μm thulium laser to perform lung nodule resection under video-assisted thoracoscopic surgery (VATS) compared with disposable linear cutting staplers. In total, 72 patients underwent thoracoscopic resection of lung nodules between January 2016 and December 2017 in the Department of Thoracic Surgery, Xuanwu Hospital. Of them, 31 underwent 2-μm thulium laser dissection, while 41 underwent the standard technique with a stapler. The primary endpoints of the study included analysis of intraoperative and postoperative course and costs. There was no significant difference between the laser and stapler groups in terms of clinical characteristics including sex, age, smoking history, and lesion size. Intraoperative evaluation demonstrated grade ≤ 2 air leaks with 29 cases in the laser group and 40 cases in the stapler group (P = 0.574). No significant intergroup differences were seen in the postoperative hospital stay (P = 0.063) or total hospital stays (and P = 0.993). Chest tube placement duration was significantly shorter in the laser group than in the stapler group (P = 0.015). However, total hospitalization costs were not significantly different between the two groups. In addition, 10 patients in each group were given a Thopaz digital chest drainage system after surgery. The postoperative hospitalization time was significantly shorter in the laser group than that in the stapler group (P = 0.049). Our results suggest that the 2-μm thulium laser has high value with minimal invasiveness, higher accuracy, and safety during thoracoscopic resection of pulmonary nodules in comparison with the controls.