Trial Information

Use of Harmonic Scalpel to Decrease Lymphatic and Chest Tube Drainage After Lymph Node Dissection With Lobectomy. A Single Center Prospective Randomized Controlled Study.

Lymph node dissection is an integral part of the surgical management of lung cancer.
Knowledge of lymph node status plays a key role in therapeutic decision making and
prognosis. Associated with this dissection comes the propensity for lymphatic leakage,
increased chest tube drainage, prolonged retention of chest tubes in the postoperative
period and increased patient length of stay. Our center performs complete mediastinal node
dissection of all relevant regional lymph nodes which generally include paratracheal,
pretracheal, subcarinal, hilar and paraesophageal nodes. The current standard of practice
for the dissection of the lymph nodes includes the use of the Harmonic Scalpel or
electrocautery. Known risk of electrocautery include localized nerve damage, cardiac
arrhythmias and damage to the tissue sample/specimen that is used for pathology. The
Harmonic Scalpel technology has recently become available for use. Current experience with
the Harmonic Scalpel suggests that there is less localized nerve damage, less incidence of
arrhythmias, less damage to the tissue sample and less lymph leakage. There is no published
data to support this hypothesis, thus the purpose of this study.