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Does fissure status affect the outcome of thoracoscopic pulmonary lobectomy?

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Abstract

Purpose

We studied fissure status and devices used to divide lung parenchyma during thoracoscopic pulmonary lobectomy (TPL).

Methods

52 consecutive TPL indicated for congenital pulmonary airway malformation or interlobar pulmonary sequestration performed between 2009 and 2019 were reviewed prospectively to compare patients with absent fissure and no visible interlobar pulmonary artery (IPA) treated by stapling (group A; n = 10), incomplete fissure with partially visible IPA treated with an Enseal® or LigaSure™ device (group I; n = 17), and complete fissure with fully visible IPA treated by electrocautery (group C; n = 25).

Results

Patient demographics were similar. Mean age at TPL was 2.82 years (range 0.03–9.81). Mean duration of follow-up was 4.77 years (range 0.33–10.19). Operative time and duration of chest tube insertion were similar (p = NS). Intraoperative blood loss was significantly lower in group C compared with group I (p = 0.028). Complications were minor bronchial artery hemorrhage during anterior-to-posterior bronchial dissection (group A: n = 1; group I: n = 1), problematic single lung ventilation (group I: n = 1), and persistent postoperative air leak (group I: n = 1).

Conclusion

While fissure status does not appear to affect the outcome of TPL in children, the choice of device for dividing lung parenchyma relies specifically on fissure status.

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Author information

Authors and Affiliations

  1. Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan

    Hiroshi Murakami, Hiroyuki Koga, Geoffrey Lane & Atsuyuki Yamataka

  2. Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan

    Shunki Hirayama & Kenji Suzuki

Authors
  1. Hiroshi Murakami
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  2. Hiroyuki Koga
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  3. Geoffrey Lane
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  4. Shunki Hirayama
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  5. Kenji Suzuki
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  6. Atsuyuki Yamataka
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Corresponding author

Correspondence to Atsuyuki Yamataka.

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Murakami, H., Koga, H., Lane, G. et al. Does fissure status affect the outcome of thoracoscopic pulmonary lobectomy?. Pediatr Surg Int 36, 57–61 (2020). https://doi.org/10.1007/s00383-019-04577-z

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  • DOI: https://doi.org/10.1007/s00383-019-04577-z

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