Discussion
esophageal and bronchial fistulas
SYSTEMIC INFLAMMATORY RESPONSE, SECONDARY, COMPLICATIONS
We found no differences between the study and control groups in primary and secondary outcome measures, including postoperative chest drainage volume, changes in the esophageal temperature during lymphadenectomy, or CRP levels. The groups also did not differ with regard to complications rates, length of postoperative in-hospital stay and mortality, but the number of lymph nodes removed was higher in the LigaSure group.The study demonstrated that the LigaSure device and the monopolar device were comparable in terms of the volume of postoperative chest drainage. We also did not find differences in the triglyceride concentrations or values of hematocrit in the pleural fluid, which could be regarded as the laboratory indicators of the quality of the sealing of lymphatic and blood vessels. Previous research in this area has yielded mixed results. One of the findings of a study by Bertolaccini et al. that compared various methods of completion of lung fissures was that the postoperative drainage amount was higher in patients operated with the LigaSure device [One of the most serious complications of lymphadenectomy are esophageal and bronchial fistulas, which may be a consequence of thermal damage of surrounding tissues during the dissection and coagulation of vessels in the paraesophageal area and under the tracheal bifurcation [To assess the role of the energy devices in systemic inflammatory response, we tested the concentration of CRP on the third postoperative day. Previous studies have shown that the CRP level increases in patients after both open and minimally invasive surgery, that levels peak on the third postoperative day, and that the maximum CRP level depends on the extent of the surgical approach: that is, it is lower after VATS than after thoracotomy [Important finding of this study was that the number of lymph nodes removed during lymphadenectomy differed significantly between the study and control groups. This difference indicate that the LigaSure device could have improved the quality of lymphadenectomy in comparison with monopolar device. The likely reason for the differences is the insulation of the tips of the instrument and the built-in tissue cutting knife [