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.
Key words
Lung cancer - malignant cell - excision - stapler
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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