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Clinical Outcomes And Cost-Effectiveness Of Different Staplers For Lung Lobectomy With Video-Assisted Thoracic Surgery

Authors Xiao X, Chang R, Gao Y

Received 13 September 2019

Accepted for publication 25 October 2019

Published 13 November 2019 Volume 2019:11 Pages 9599—9607


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Antonella D'Anneo

Xiaoxiong Xiao, Ruimin Chang, Yang Gao

Thoracic Surgery Department, Xiangya Hospital Central South University, Changsha 410008, Hunan, People’s Republic of China

Correspondence: Yang Gao
Thoracic Surgery Department, Xiangya Hospital Central South University, 87 Xiangya Road, Changsha, Hunan 410008, People’s Republic of China
Tel +86-13973171096

Purpose: The aim of this study was to compare intra-operative adverse events (AE), post-operative outcomes, and costs of three different types of Echelon staplers (manual activated SC45A and electrical power-activated PSE45A & PSEE60A) used during video-assisted thoracic surgery (VATS) for lung lobectomy.
Patients and methods: We carried out a retrospective chart review of patients undergoing VATS lobectomies using one of three staplers (SC45A, PSE45A, or PSEE60A) during a 2-year period at our institution. We compared intra-operative AEs, post-operative outcomes (drainage volume, chest tube duration, prolonged air leaks [PALs]), endoscopic product costs [ECs], and hospitalization costs [HCs]) amongst the three stapler groups.
Results: In all 204 peripheral lung cancer patients were included in the study (95 in the SC45A group, 72 in the PSE45A group, and 37 in the PSEE60A group). We observed intra-operative AEs in 6 patients of the SC45A group, in 4 of the PSE45A group, and in 1 of the PSEE60A group (P>0.05). Drainage volumes among the three groups were similar. The mean chest tube duration was shorter]st in the PSE45A group followed by those in the PSEE60A and SC45A groups (P<0.05). PALs were lowest in the PSE45A group and highest in the SC45A group (P<0.05). The mean EC in the PSEE60A group was significantly higher than those in the other two groups (P<0.05). We found no statistically significant differences in terms of HCs among groups.
Conclusion: The three endoscopic staplers had similar incidences of intra-operative AEs when used for lobectomy with VATS. Use of the PSE45A stapler was associated with the shortest chest tube duration and least PALs, while use of the PSEE60A resulted in the highest EC rate.

Keywords: VATS, hospitalization costs, HCs, prolonged pulmonary air leaks, PALs, endoscopic product costs, ECs

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