2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.07A.02 Staple Formation by Endostapler and Bronchial Wall Thickness in Pulmonary Lobectomy: Prospective Observational Study

EP.07A.02 Staple Formation by Endostapler and Bronchial Wall Thickness in Pulmonary Lobectomy: Prospective Observational Study

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This prospective observational study conducted at the Cancer Institute Hospital in Tokyo, Japan, aims to evaluate staple formation based on the type of endostapler cartridge used and bronchial wall thickness in patients undergoing pulmonary lobectomy. The study included 80 patients between April 2021 and March 2023 who had either primary lung cancer or metastatic lung tumors. Researchers utilized the ECHELON FLEX Powered Plus Stapler and the ENDOPATH ECHELON Reloads with Gripping Surface Technology (GST) cartridges (Gold, Green, or Black) and classified cartridges during surgery based on intraoperative findings and surgeon experience.<br /><br />Bronchial stump thickness was measured, and staple formations were analyzed post-procedure. Staple formation was scored on a scale from 1 to 3, evaluating the shape of the staples. Findings highlight that the Green and Black cartridges were more frequently used in patients with thicker bronchial walls, showing a higher tendency for better staple formation scores compared to the Gold cartridge. Particularly, the Green/Black cartridges resulted in a higher proportion of perfect B-shaped closures, indicating a score of 3.<br /><br />The study found significant correlations between bronchial stump thickness and patient characteristics such as gender and height, with higher formation scores observed in men and women over 160 cm tall when using Green/Black cartridges. Despite differences in staple formation, there were no significant differences in complications, such as bronchopleural fistula, postoperatively.<br /><br />Overall, the study suggests that while all cartridges perform well clinically, Green or Black cartridges might be more suitable for thicker bronchial walls, particularly in taller patients. This insight can aid in cartridge selection based on patient-specific characteristics, optimizing surgical outcomes in pulmonary lobectomies.

Asset Subtitle

Masayuki Nakao

Meta Tag

Speaker Masayuki Nakao

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

pulmonary lobectomy

endostapler cartridge

bronchial wall thickness

ECHELON FLEX Stapler

Green and Black cartridges

staple formation

bronchial stump thickness

patient characteristics

surgical outcomes

Cancer Institute Hospital Tokyo