The differences in histological changes among pulmonary vessels divided with an energy device

Yoshiya, Tomoharu; Mimae, Takahiro; Tsubokawa, Norifumi; Sasada, Shinsuke; Tsutani, Yasuhiro; Kushitani, Kei; Takeshima, Yukio; Miyata, Yoshihiro; Okada, Morihito

doi:10.1093/icvts/ivy072

Cited by 3 publications

(2 citation statements)

References 20 publications

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“…Adenocarcinoma is the most common form of lung cancer and has recently been classified into pre-invasive adenocarcinoma [atypical adenocarcinoma hyperplasia (AAH), adenocarcinoma in situ (AIS)], minimally invasive adenocarcinoma (MIA), and invasive adenocarcinoma (IAC) (3). The 5-year disease-free survival rates in AIS and MIA are 100% or close to 100%, which are significantly higher than that in IAC (38-86%, depending on the predominant histological subtypes) (4,5). Therefore, the accurate preoperative diagnosis of lung adenocarcinoma is critical for clinical decision-making processes and the assessment of prognoses.…”

Section: Introductionmentioning

confidence: 99%

Non-contrast and contrast enhanced computed tomography radiomics in preoperative discrimination of lung invasive and non-invasive adenocarcinoma

Sun

Zhao

Kuang³

et al. 2022

Front. Med.

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ObjectiveThis study aimed to assess the value of radiomics based on non-contrast computed tomography (NCCT) and contrast-enhanced computed tomography (CECT) images in the preoperative discrimination between lung invasive adenocarcinomas (IAC) and non-invasive adenocarcinomas (non-IAC).MethodsWe enrolled 1,185 pulmonary nodules (478 non-IACs and 707 IACs) to build and validate radiomics models. An external testing set comprising 63 pulmonary nodules was collected to verify the generalization of the models. Radiomic features were extracted from both NCCT and CECT images. The predictive performance of radiomics models in the validation and external testing sets were evaluated and compared with radiologists’ evaluations. The predictive performances of the radiomics models were also compared between three subgroups in the validation set (Group 1: solid nodules, Group 2: part-solid nodules, and Group 3: pure ground-glass nodules).ResultsThe NCCT, CECT, and combined models showed good ability to discriminate between IAC and non-IAC [respective areas under the curve (AUCs): validation set = 0.91, 0.90, and 0.91; Group 1 = 0.82, 0.79, and 0.81; Group 2 = 0.93, 0.92, and 0.93; and Group 3 = 0.90, 0.90, and 0.89]. In the external testing set, the AUC of the three models were 0.89, 0.91, and 0.89, respectively. The accuracies of these three models were comparable to those of the senior radiologist and better those that of the junior radiologist.ConclusionRadiomic models based on CT images showed good predictive performance in discriminating between lung IAC and non-IAC, especially in part solid nodule group. However, radiomics based on CECT images provided no additional value compared to NCCT images.

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Section: Introductionmentioning

confidence: 99%

Non-contrast and contrast enhanced computed tomography radiomics in preoperative discrimination of lung invasive and non-invasive adenocarcinoma

Sun

Zhao

Kuang³

et al. 2022

Front. Med.

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“…In histological and immunohistochemical analysis of pulmonary vessels divided by LigaSure, it was found that LigaSure sealing result in sealing of the adventitia only, without complete fusion of the layers of the PA walls. It remains unclear whether these findings have a clinical impact (6,7). As a first step for using energy devices in anatomical lung resections, the proximal side of the pulmonary branch were ligated and just after sealed and divided with the devices (10,11).…”

Section: Energy Sealing Devices In Anatomical Lung Resectionmentioning

confidence: 99%

Energy devices for pulmonary artery sealing in video-assisted thoracoscopic surgery (VATS) segmentectomy: literature review and surgical technique

Katz¹,

Liberman²

2022

J Vis Surg

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Heat production during pulmonary artery sealing with energy vessel-sealing devices in a swine model

Goudie

Oliveira

Thiffault

et al. 2020

Interactive CardioVascular and Thoracic Surgery

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OBJECTIVES Energy vessel-sealing devices are being increasingly utilized to seal pulmonary artery (PA) branches during lobectomy. Heat from these devices can potentially injure surrounding tissues. We evaluated heat production from devices in a live animal model. METHODS PA branches were sealed in pigs with 4 energy vessel-sealing devices: 2 ultrasonic (US), 1 advanced bipolar or 1 mixed US and bipolar (mixed) device. Thermocouples were implanted in tissue surrounding the PA branch being sealed to measure tissue temperature. A thermal camera measured the sealing site and the temperatures of the instruments. Pathological analysis was performed on PA stumps to identify thermal damage. RESULTS A total of 37 PA branches were sealed in 4 pigs. Maximum tissue heat measured by the thermocouples for the 2 US, advanced bipolar and mixed devices was 42, 39, 42 and 46°C, respectively. The mean tissue temperatures at the site of the sealing measured with the thermal camera were 78, 75, 70 and 82°C (P = 0.834) and the mean instrument blade temperatures were 224, 195, 83 and 170°C (P = 0.000005) for the 2 US, advanced bipolar and mixed devices, respectively. The mean diameter of the region with tissue reaching 60°C or more measured with the thermal camera was between 4 and 6 mm for the 4 devices (P = 0.941). On pathological analysis, PA stumps had either thermal damage on the adventitia and external media (26/37) or transmural damage (11/37) at 1 mm from sealed site. CONCLUSIONS A 3-mm safety margin between the instrument blades and vital structures is recommended. Instrument blades can reach high temperatures that may cause tissue damage.

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The differences in histological changes among pulmonary vessels divided with an energy device

Abstract: Surgeons should consider that dividing the pulmonary vessels with a vessel-sealing device might have more histological impact on the layers of the wall of the PA than on those of the PV, although it remains unclear whether these findings constitute a clinical risk.

Cited by 3 publications

References 20 publications

Non-contrast and contrast enhanced computed tomography radiomics in preoperative discrimination of lung invasive and non-invasive adenocarcinoma

Non-contrast and contrast enhanced computed tomography radiomics in preoperative discrimination of lung invasive and non-invasive adenocarcinoma

Energy devices for pulmonary artery sealing in video-assisted thoracoscopic surgery (VATS) segmentectomy: literature review and surgical technique

Heat production during pulmonary artery sealing with energy vessel-sealing devices in a swine model

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