P1.08-053 Thoracoscopic Partial Resection for Peripheral Pulmonary Nodules without Using Stapler

Abstract

Advances in radiologic studies, such as high resolution computed tomography (HRCT), have enabled frequent detection of small lung nodules. Accordingly, opportunity for sublobar resections for small lesions has increased. Recently, we have introduced thoracoscopic partial resection for peripheral pulmonary small nodules without using stapler to reduce the cost of operation. After detecting the peripheral nodules, partial resection was performed with electrocautery and two different methods of surface sealing were followed. Coagulation method (C method) with SOFT COAG alone and Coagulation-suturing method (CS method) with SOFT COAG combined with continuous suturing by an absorbable barbed suture. The clinical outcome of the two methods was retrospectively compared in this study. C method was performed in 19 lesions of 18 cases and CS method was performed in 17 lesions of 16 cases. Primary lung cancer was most frequent as 19 lesions of 18 cases. There was no significant difference between the two groups in size and depth of the lesions. Operation time was significantly longer in CS method than in C method. Postoperative air leakage was complicated to 4 cases in C method and one of them needed re-do surgery, whereas only one case in CS method had temporary air leakage. Postoperative computed tomography revealed cavitation in 3 cases of C method and in 4 cases of CS method all without related symptoms. There was no local recurrence in resected sites. C method was technically easy to perform, but air leakage may be possibly prolonged after surgery. CS method may have an advantage of less air leakage than C method, but technical learning is important to shorten operation time.