To investigate the effect of the amputation order of pulmonary artery and pulmonary artery on pulmonary residual blood volume in total thoracoscopic lobectomy.

Sixty-eight patients who were scheduled to underwent total thoracoscopic lobectomy from June 2015 to April 2019 in Beijing Aerospace General Hospital were selected. The patients were divided into first amputation pulmonary artery group and first amputation pulmonary vein group by random envelope method with 34 cases in each group. Five cases in first amputation pulmonary artery group and 4 cases in first amputation pulmonary vein group were excluded because of the procedure modification or the fragmentation of the specimen during the course of operation. In the end, 29 cases were enrolled in first amputation pulmonary artery group and 30 cases in first amputation pulmonary vein group. In first amputation pulmonary vein group, all arteries were ligated before interruption of the veins; and in first amputation pulmonary artery group had a reverse sequence. The perioperative period status were recorded, and the crude pulmonary quality, dry pulmonary quality, pulmonary residual blood volume and adjusted pulmonary residual blood ratio were measured or calculated.

All 59 patients were operated successfully. No serious complications occurred, no perioperative death occurred, and no patients needed blood transfusion. There was no statistical difference in the incidence of minor complications between first amputation pulmonary artery group and first amputation pulmonary vein group: 27.6% (8/29) vs. 33.3% (10/30), P>0.05. There were no statistical differences in operative time, transoperative bleeding volume, pulmonary residual blood volume, crude pulmonary quality, dry pulmonary quality, adjusted pulmonary residual blood ratio, hemoglobin difference before and after surgery, postoperative drainage time and postoperative hospitalization time between 2 groups (P>0.05).

The amputation order of pulmonary artery and pulmonary vein sequence of vessel interruption during total thoracoscopic lobectomy has no effect on the pulmonary residual blood volume, can be reasonably selected according to the intraoperative situation.

Pneumonectomy; Thoracoscopes; Pulmonary veins; Pulmonary artery