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Impact of Transcollation technology in thoracic surgery: a retrospective study.

OBJECTIVES
This is a retrospective study to evaluate the effectiveness of Transcollation technology (TT) in reducing blood loss and improving the postoperative outcome in patients with severe pleural-parenchymal adhesions who underwent major lung resection.


METHODS
Between November 2010 and February 2012, TT was used to perform lysis of adhesions and dissection in 110 patients (TT Group) who underwent major lung resections via thoracotomy. Conventional electrocoagulation was used in 129 patients (EC Group). Operative time, daily drainage amount at 24, 48 and 72 h, pre- and postoperative haemoglobin levels, need for blood transfusion, intra- and postoperative air leaks and duration of chest tube placement and hospital stay were analysed.


RESULTS
No adverse events related to the TT system occurred, including reoperation for bleeding. The mean operating time was 95.2 ± 35.4 min in the TT Group versus 117.1 ± 73.4 min in the EC Group (P = 0.017). The mean postoperative haemoglobin level was 12.3 ± 3.9 g/dl versus the preoperative level of 13.8 ± 2.2 g/dl in the TT Group (P = 0.154) and 9.6 ± 2.8 vs 13.2 ± 2.1 g/dl in the EC Group (P = 0.001). Only 2 patients (1.8%) received postoperative blood transfusion in the TT Group vs 19 patients (14.7%) in the EC Group (P = 0.001). Intraoperative and postoperative (24 h) air leak rates were 4.7% (n = 5) and 2.8% (n = 3) in the TT Group vs 13.9% (n = 18) and 12.4% (n = 16) in the EC Group (P = 0.001), respectively. The mean duration of chest tube placement was shorter in the TT Group (4.7 ± 0.8 vs 6.8 ± 1.1 days, P = 0.013), as well as the mean hospital stay (5.3 ± 1.9 vs 7.5 ± 0.3 days, P = 0.007).


CONCLUSIONS
The use of TT seems to reduce haemorrhage occurrence and postoperative hospital stay after major lung resection in patients with severe pleural-parenchymal adhesions.