{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T08:01:11Z","timestamp":1781078471018,"version":"3.54.1"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T00:00:00Z","timestamp":1778284800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Intraoperative assessment of resection margins during pulmonary resection is limited by tissue compression and distortion caused by conventional staplers, which hinder direct pathological evaluation of the anatomical resection margin. We report our initial clinical experience with a novel asymmetric linear stapler (NALS) designed to provide direct access to the specimen-side anatomical resection margin for intraoperative histologic assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed patients who underwent pulmonary resection using the NALS between July 2024 and December 2025. Intraoperative frozen-section examination was performed for parenchymal and\/or bronchial margins when malignancy was suspected or confirmed. Margin status, margin distance, and frozen\u2013permanent pathological concordance were analysed descriptively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 226 patients who underwent pulmonary resection using the NALS, 206 resection margins (144 parenchymal and 62 bronchial) were evaluated. Intraoperative frozen-section examination identified margin positivity in 12 margins (5.8%). Residual tumour was confirmed on permanent pathology in 4 of 8 parenchymal frozen-positive margins, whereas all bronchial frozen-positive margins showed benign or reactive changes. No false-negative frozen-section findings were identified. Among negative margins with available measurements, 66.7% of parenchymal margins and 84.5% of bronchial margins measured at least 10 mm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this initial experience, intraoperative margin assessment using the NALS was feasible and enabled structured evaluation of the anatomical resection margin during pulmonary resection. Because no control group using conventional staplers was included, these findings should be interpreted as a feasibility assessment rather than evidence of superiority over standard stapling devices. Further multicentre studies with controlled comparisons and long-term oncologic follow-up are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/icvts\/ivag140","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T11:43:05Z","timestamp":1778154185000},"source":"Crossref","is-referenced-by-count":0,"title":["Intraoperative Assessment of Anatomical Resection Margin Using a Novel Asymmetric Linear Stapler: An Initial Single Institution Experience"],"prefix":"10.1093","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1935-2140","authenticated-orcid":false,"given":"Yooyoung","family":"Chong","sequence":"first","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital, Chungnam National University School of Medicine , Daejeon 35015,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0214-0296","authenticated-orcid":false,"given":"Kyung-Hee","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Pathology, Chungnam National University Hospital, Chungnam National University School of Medicine , Daejeon 35015,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5833-5530","authenticated-orcid":false,"given":"Hyun Jin","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital, Chungnam National University School of Medicine , Daejeon 35015,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8074-0900","authenticated-orcid":false,"given":"Calvin S.H","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong , Shatin, N.T., Hong Kong,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9571-6164","authenticated-orcid":false,"given":"Sandeep J","family":"Khandhar","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Virginia Cancer Specialists, Inova Fairfax Hospital , Fairfax, VA 22031,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Durand","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Department, Groupe Hospitalier Priv\u00e9 Ambroise Par\u00e9 Hartmann , Neuilly-Sur-Seine 92200,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihiko","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of General Thoracic, Breast and Pediatric Surgery, Fukuoka University School of Medicine and Hospital , 7-45-1 Nanakuma, Jonan-Ku, Fukuoka City, Fukuoka, 814-0180,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3535-0081","authenticated-orcid":false,"given":"Mingyon","family":"Mun","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research , Tokyo 135-8550,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8492-0351","authenticated-orcid":false,"given":"Min-Woong","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Chungnam National University Hospital, Chungnam National University School of Medicine , Daejeon 35015,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,9]]},"reference":[{"key":"2026061003311928100_ivag140-B1","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1093\/ejcts\/ezw242","article-title":"Significance of R1-resection at the bronchial margin after surgery for non-small-cell lung cancer","volume":"51","author":"Lee","year":"2017","journal-title":"Eur J Cardiothorac Surg"},{"key":"2026061003311928100_ivag140-B2","doi-asserted-by":"publisher","first-page":"1815","DOI":"10.1016\/j.jtho.2020.09.006","article-title":"Complete resection in lung cancer surgery: from definition to validation and beyond","volume":"15","author":"Rami-Porta","year":"2020","journal-title":"J Thorac Oncol"},{"key":"2026061003311928100_ivag140-B3","doi-asserted-by":"crossref","first-page":"2583","DOI":"10.3390\/cancers13112583","article-title":"The evolving concept of complete resection in lung cancer surgery","volume":"13","author":"Rami-Porta","year":"2021","journal-title":"Cancers (Basel)"},{"key":"2026061003311928100_ivag140-B4","doi-asserted-by":"publisher","first-page":"720","DOI":"10.1097\/00000658-199412000-00003","article-title":"Video-assisted thoracic surgery. 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