Safety of a Novel Microwave Surgical Instrument for Lung Parenchyma Dissection During Segmentectomy.

Background. The choice between electrocautery or automatic suturing instruments for dissection of the lung parenchyma along the intersegmental plane during lung segmentectomy remains controversial. We hypothesized that a novel microwave surgical instrument (MSI) for dissecting the lung parenchyma could have excellent sealing effects. We examined the feasibility and safety of lung parenchymal dissection using a MSI during lung segmentectomy. Methods. This was a prospective clinical study of lung segmentectomy involving dissection of the entire intersegmental plane using a MSI. Complications related to sealing of the lung parenchyma were evaluated and perioperative outcomes were compared to those of patients who underwent lung segmentectomy using automatic suturing instruments. Propensity score-matched comparisons were used to assess the potential impact of selection bias. Results. Lung segmentectomy using a MSI was successfully performed in 30 patients. According to the propensity score matching analysis, intraoperative blood loss, length of hospital stay, and postoperative complications of the microwave group were significantly lesser (P = .019, .003, and .008, respectively) compared to those of the control group (n = 66). Prolonged air leakage was not observed. There were two cases of subcutaneous emphysema after removal of the chest tube, but no other grade 2 or higher complications were observed. No mortality occurred within 30 or 90 days postoperatively. Conclusions. The use of a MSI for lung parenchymal dissection was associated with lower blood loss during surgical procedures, reduced air leakage after the operation, and fewer postoperative complications. (C) 2020 by The Society of Thoracic Surgeons