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A no-touch technique for pulmonary wedge resection of lung cancer

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Abstract

Objective

Many of the surgical patients with lung cancer die by metastasis originated from circulating tumor cells (CTCs) which are seeds of metastases. A ring-shaped catching forceps, which generates the great pressure by compression, may reduce the risk of tumor cell spreading. Here, we investigated the efficacy of such forceps based on CTC occurrence.

Methods

Twenty-three patients with clinical stage IA lung cancer who underwent a pulmonary wedge resection were investigated in a clinical-pathological manner. They were divided into those treated using ring forceps catching without tumor release (R group) (n = 16) and non-complete use of ring forceps (N group) (n = 7), then were determined circulating tumor cells (CTCs).

Results

Radiographic findings, tumor location, pathological diagnosis, and stapling method were not significantly different between the groups. The risk of detection of CTCs after surgery was significantly lower in group R (12.5 vs. 85.7%, p = 0.02), whereas there were no significant differences found in risk of negative-stapled margin cytology, pre-OP CTC detection, V (+), Ly (+), and Pl (+).

Conclusions

Patients who underwent pulmonary wedge resection of lung cancer had low chance of CTC detection after surgery when they were treated with ring forceps without tumor release, which might become a no-touch isolation technique.

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Acknowledgements

The authors thank Dr. Hiroshi Maruyama and Dr. Yuko Torii (Department of Pathology, Hoshigaoka Medical Center) for their contributions to the cytological–pathological diagnoses.

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Correspondence to Noriyoshi Sawabata.

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None of the authors are supported by funding to declare in regard to this study.

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None of the authors have conflicts of interest to declare in regard to this study.

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Sawabata, N., Hyakutaka, T., Kawaguchi, T. et al. A no-touch technique for pulmonary wedge resection of lung cancer. Gen Thorac Cardiovasc Surg 66, 161–167 (2018). https://doi.org/10.1007/s11748-017-0863-0

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  • DOI: https://doi.org/10.1007/s11748-017-0863-0

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