B-006RESULTS OF LI-THO TRIAL: A PROSPECTIVE RANDOMIZED STUDY ON EFFECTIVENESS OF LIGASURE® IN LUNG RESECTIONS

Abstract

The Electro-thermal bipolar tissue-sealing system (LigaSure®-Covidien) in lung resections is still undefined (although approved by FDA with limitations). Prospective randomized study of 100 consecutive patients undergoing lobectomy. After muscle-sparing-thoracotomy and classification of lung fissures (Craig–Walker's), patients with fissure 2-4 were randomized to Stapler-Group or LS-Group. In LS-Group, only LS was used, instead of staplers, for fissure completion. Cost-benefit evaluation was performed using Pareto-optimal-analysis. There were no significant differences between groups (demographic and baseline characteristics). No patients were withdrawn from study; no adverse-effects were recorded. There was no mortality or major complications. There were no statistically significant differences between outcomes in LS-Group compared with Staplers-Group for operative-time, or morbidity. In LS Group, there was a non-significant increase of postoperative air-leaks in the first 24 hours postoperatively, and a statistically significant increase of drainage amount, without differences in hospital length of stay. LS Group had favourable multi-criteria analysis of cost/benefit ratio with good Pareto optimality. LS is a safe device for lung resections and can be a valid alternative to staplers. LS allows for functional lung tissue preservation. LS is cost equivalent to Staplers. Nevertheless, larger series will be needed. All authors have declared no conflicts of interest.