Thorac Cardiovasc Surg 2006; 54(6): 418-424
DOI: 10.1055/s-2006-924104
Original Thoracic

© Georg Thieme Verlag KG Stuttgart · New York

Spread of Malignant Cells in the Surgical Margin with Stapled Excision of Lung Cancer: Comparison of Aggressive Clump and Less Traumatic Jaw Closure Type Staplers

N. Sawabata1 , S.-I. Takeda2 , M. Inoue1 , T. Tokunaga1 , M. Koma2 , H. Maeda1 , 2
  • 1Division of General Thoracic Surgery, Department of Surgery (E-1), Osaka University, Graduate School of Medicine, Suita, Osaka, Japan
  • 2Division of Surgery, Toneyama National Hospital, Toyonaka, Osaka, Japan
Further Information

Publication History

Received October 25, 2005

Publication Date:
07 September 2006 (online)

Abstract

Background: During stapled excision of lung cancer tissue, malignant cells can spread in the surgical margin. Stapling methods can be classified as aggressive clumping (AC) and less traumatic jaw closing (LTJC) types, thus the ratio of malignant margins may differ between stapler types. Methods: The malignant status of the stapled margin was retrospectively investigated in 112 cases using a cytology technique. Stapler type, maximum tumor diameter, distance from surgical margin, thoracotomy type, and tumor location were used as variables. In addition, clinical results of excision cases were assessed. Results: The ratio of malignant margins was 22/54 (41 %) in the AC group and 11/58 (19 %) in the LTJC group (p = 0.01). Multivariate analysis revealed that the stapling method and tumor location were an independently significant factor. Surgical margin recurrence occurred only in 4 (57 %) of 7 cases with malignant margin. Conclusions: The AC type method showed a greater potential to spread malignant cells, thus there seems to be a higher possibility of regional relapse with that technique.

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M.D. Noriyoshi Sawabata

Division of General Thoracic Surgery
Department of Surgery (E-1)
Osaka University
Graduate School of Medicine

2-2 Yamadaoka, Suita

560-8552 Osaka

Japan

Phone: + 81 66 81 79 31 52

Fax: 81 66 81 79 31 63

Email: sawabata@surg1.med.osaka-u.ac.jp

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