energy devices versus electrocoagulation in video-assisted thoracoscopic lobectomy: a propensity-match cohort study

BaCKgrOuND: The aim of the study was to compare the effect on perioperative outcome of intraoperative use of different devices for tissue dissection (electrocoagulation [eC] or energy devices [eD]) in patients who underwent video-assisted thoracoscopic surgery (VaTS) lobectomy for lung cancer. MeTHODS: We retrospectively reviewed 191 consecutive patients who underwent VaTS lobectomy, divided into two cohorts: eD (117 patients), and eC (74 patients); after propensity score matching, 148 patients were extracted, 74 for each cohort. The primary endpoints considered were complication rate and 30-day mortality rate. The secondary endpoints considered were length of stay (LOS) and the number of lymph nodes harvested. reSuLTS: The complication rate did not differ between the two cohorts (16.22% eC group, 19.66% eD group, P=0.549), before and after propensity matching (16.22% for both eC and eD group, P=1.000). The 30-day mortality rate was 1 in the overall population. Median LOS was 5 days for both groups, before and after propensity match, with the same interquartile range, (IQR: 4-8). ED group had a significantly higher median number of lymph nodes harvested (ED median: 18, IQR: 12–24; EC median: 10, IQR: 5-19; P=0.0002). The difference was confirmed after the propensity score matching (eD median: 17, iQr: 13–23; eC median: 10, iQr: 5-19; P=0.0008). CONCLuSiONS: eD dissection during VaTS lobectomy did not lead to different complication rates, mortality rates, and LOS compared to EC tissue dissection. ED use led to a significantly higher number of intraoperative lymph nodes harvested compared to eC use.