Is “en masse” lobectomy feasible in the recent era?

Shirakusa, Takayuki; Yamashita, Shinichi

doi:10.1007/s11748-013-0209-5

Cited by 1 publication

(2 citation statements)

References 4 publications

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“…47 Alternatively, all structures can be closed in one single maneuver (en masse). 48-50 Described complications are risk of artery vein, 51 bronchovascular or bronchopleural fistulae. 50,52 The first is considered rare, while bronchovascular or bronchopleural fistulae could happen independent of the way the structures are closed.…”

Section: Discussionmentioning

confidence: 99%

“…Although en mass e technique is not preferred in humans, the technique may be used in selected cases, such as emergency interventions or neoplasia. 49,50 In veterinary surgery, en masse is the preferred technique for VATS lobectomy in small animals, 3-5,53,54 probably due to patients’ size and absence of reports of fistulae. In future studies of the resorbable implant, the risk of development of fistula needs to be considered.…”

Section: Discussionmentioning

confidence: 99%

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Resorbable Self-Locking Implant for Lung Lobectomy Through Video-Assisted Thoracoscopic Surgery: First Live Animal Application

et al. 2018

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The aim of this pilot test was to test a new self-locking resorbable implant for hilum occlusion during a video-assisted thoracoscopic lung lobectomy in a surviving pig model. Once the thoracic cavity was assessed and structures identified, the right middle lobe and its respective hilum were exposed. The implant was introduced with a semiclosed loop through a working channel and positioned around the pulmonary lobe. Occlusion was performed with a conventional Crile forceps and a laparoscopic Kelly forceps. Lobe section was done with laparoscopic Metzenbaum scissors and tissue removal through the dorsal access. No signs of pneumothorax or bleeding were observed during a 60-day follow-up. Necropsy findings showed minimal pleuritis in caudal access and in the lobar stump. A granulomatous formation was found around a dense, amorphous material, which was identified as remains of a small part of the implant. Histopathological findings showed signs of a chronic healing process without other alterations. The resorbable implant LigaTie appears to exhibit similar handling and application characteristics during surgery as nonsurgical tie wraps. The resorbable implant avoids the uncontrolled substances not suitable for implants of conventional ties. The results of this pilot test suggested the resorbable implant's mechanical properties provided effective tissue support to complete the healing of the pulmonary hilum.

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