In centrally located lung tumors, salvage pulmonary resections pose challenges due to adhesions between the pulmonary parenchyma, chest wall, and hilum. This study aimed to investigate the surgical outcomes associated with Cavitron Ultrasonic Surgical Aspirator (CUSA) usage in thoracoscopic salvage pulmonary resections. Patients with centrally located advanced-stage lung tumors who underwent salvage anatomic resections following systemic or radiotherapy were included. They were categorized into CUSA and non-CUSA groups, and perioperative parameters and surgical outcomes were analyzed. Results: The study included 7 patients in the CUSA group and 15 in the non-CUSA group. Despite a longer median surgical time in the CUSA group (3.8 h vs. 6.0 h,p= 0.021), there was a significant reduction in blood loss (100 mL vs. 250 mL,p= 0.014). Multivariate analyses revealed that the use of CUSA and radiotherapy had opposing effects on blood loss (β: −296.7, 95% CI: −24.8 to −568.6,p= 0.034 and β: 282.9, 95% CI: 19.7 to 546.3,p= 0.037, respectively). In conclusion, while using CUSA in the salvage anatomic resection of centrally located lung cancer may result in a longer surgical time, it is crucial in minimizing blood loss during the procedure.
对于中央型肺癌，挽救性肺切除术因肺实质、胸壁及肺门间粘连而面临挑战。本研究旨在探讨胸腔镜挽救性肺切除术中应用Cavitron超声外科吸引器（CUSA）的手术效果。研究纳入接受全身治疗或放疗后行挽救性解剖性切除术的中央型晚期肺癌患者，将其分为CUSA组与非CUSA组，并分析围手术期参数及手术结果。结果显示：CUSA组7例，非CUSA组15例。尽管CUSA组中位手术时间更长（3.8小时 vs. 6.0小时，p=0.021），但术中失血量显著减少（100 mL vs. 250 mL，p=0.014）。多变量分析显示，CUSA使用与放疗对失血量呈相反影响（β值分别为-296.7，95% CI：-24.8至-568.6，p=0.034；β值为282.9，95% CI：19.7至546.3，p=0.037）。结论：在中央型肺癌挽救性解剖切除术中使用CUSA虽可能延长手术时间，但对减少术中失血具有关键作用。
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