Application Of Two-Stapler Method In Utility-Port Video-Assisted Thoracoscopic Upper Lobectomy

Objective To compare the differences in intraoperative blood loss,postoperative catheterization time,the number of lymph node dissection groups in groups 10 and 11 postoperative complications and surgery cost in the application of Two-stapler Method with Traditional Method in Single-port Video-assisted Thoracoscopic Upper Lobectomy.Methods A retrospective analysis of patients who underwent Single-port Video-assisted Thoracoscopic Upper Lobectomy in Hangzhou First People’s Hospital from 2019 to 2020,the pulmonary artery was ligated with silk thread and reinforced with titanium clips,the pulmonary vein and bronchus were severed with linear cutting closure devices under the Single-port Video-assisted Thoracoscopic Upper Lobectomy was called the Two-stapler Method group;under the Single-port Video-assisted Thoracoscopic Upper Lobectomy withlinear cutting closure devices to seal the pulmonary artery,pulmonary vein and bronchus was called the traditional method group.All patients underwent Single-port Video-assisted Thoracoscopic Upper Lobectomy under general anesthesia with double-lumen intubation.By comparing the Two-stapler Method with Traditional Method underwent Single-port Video-assisted Thoracoscopic Upper Lobectomy,the intraoperative blood loss and the rate of occurrence major bleeding converted to thoracotomy,operation duration,postoperative catheterization time,the number of lymph node dissection groups in groups 10 and 11,postoperative complications and surgery costs were used to evaluate whether the Two-stapler Method was worth popularizing and applying to Thoracic Surgery.Results In 57 patients,23 patients had left upper lobectomy and 34 patients had right upper lobectomy.Among the patients treated with the Two-stapler Method and the Traditional Method in each lung lobe,in the left upper lung 12 patients（52.17%）under Two-stapler Method group,in the left upper lung 11 patients（47.83%）under Traditional Method group;in the right upper lung 18 patients（52.94%）apply Two-stapler Method,in the right upper lung 16 patients（47.06%）apply Traditional Method.None of the above patients had intraoperative bleeding converted to thoracotomy and severe postoperative complications（such as bronchopleural fistula,arteriovenous fistula,and hemothorax,etc.）In terms of postoperative complications,the difference was not statistically significant.The Two-stapler Method to seal the pulmonary artery will not cause the ligation of blood vessels to tear and hemorrhage during the operation,and there will be no serious complications such as ligature slippage and bleeding after operation.Compared with the Traditional group,the operation cost of the right upper lung two-staple group is 25768.41±3310.11 yuan,and the operation cost of the traditional group was 29594.65±2955.16 yuan（P=0.001）;the left upper lung two-staple group was 24563.43±4129.12 yuan,and the traditional group was 28955.86±3500.88 yuan（P=0.012）.the surgery cost is significantly lower,and the difference is statistically significant（P<0.05）.Conclusion The application of the Two-shot Method in Utility-port Video-assisted Thoracoscopic Upper Lobectomy has no statistical difference with the Traditional Method,but in terms of economy,the Two-stapler Method has obvious advantages.Compared with the Traditional Method,the Two-stapler Method can significantly reduce the cost of surgery.Two-stapler Method is worthy of clinical application.