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基于吻合器的胸腔镜肺段切除术后节段计数法预测肺功能和体积的效果。

Efficacy of the Segment-Counting Method in Predicting Lung Function and Volume Following Stapler-Based Thoracoscopic Segmentectomy.

机构信息

Department of Thoracic Surgery, St. Luke's International Hospital, Tokyo, Japan.

Department of Thoracic Surgery, The University of Tokyo Hospital, Tokyo, Japan.

出版信息

Ann Thorac Cardiovasc Surg. 2022 Apr 20;28(2):121-128. doi: 10.5761/atcs.oa.21-00111. Epub 2021 Sep 23.

Abstract

PURPOSE

To investigate the accuracy of a segment-counting method in predicting lung function and volume after stapler-based thoracoscopic segmentectomy in comparison with lobectomy.

METHODS

Between 2014 and 2018, patients who underwent these procedures were retrospectively reviewed. Thoracic computed tomography and spirometry data before and 1 year after the surgery were assessed. We evaluated the differences between the predicted values using a segment-counting method and the actual postoperative values for lung function and volume in each group. Sub-analyses were also performed to assess the impact of the number of staples and resected segments in predicting patient outcomes.

RESULTS

We included 116 patients (segmentectomy, 69; lobectomy, 47). Actual postoperative lung function and volume values matched the predicted values in the stapler-based segmentectomy group, and significantly exceeded the predictions in the lobectomy group (P <0.01). Sub-analyses revealed lower postoperative lung function values than predicted existed after single segmentectomy, with an odds ratio of 3.29 (95% confidence interval: 1.02-10.70, P = 0.04) in a multivariable analysis. The degree of predicted error regarding lung function was negligible.

CONCLUSIONS

The segment-counting method was useful in predicting lung function after stapler-based thoracoscopic segmentectomy. Segmentectomy rarely yielded lower-than-predicted lung function and volume values.

摘要

目的

与肺叶切除术相比,研究基于吻合器的胸腔镜肺段切除术的肺功能和体积的节段计数预测方法的准确性。

方法

回顾性分析 2014 年至 2018 年间接受这些手术的患者。评估手术前后的胸部计算机断层扫描和肺功能检查数据。我们评估了节段计数法预测值与每组术后肺功能和体积的实际值之间的差异。还进行了亚组分析,以评估吻合器数量和切除节段数量对预测患者结局的影响。

结果

我们纳入了 116 例患者(肺段切除术 69 例,肺叶切除术 47 例)。基于吻合器的肺段切除术组的实际术后肺功能和体积值与预测值相匹配,且显著超过肺叶切除术组的预测值(P<0.01)。亚组分析显示,单肺段切除术后的术后肺功能值低于预测值,多变量分析的比值比为 3.29(95%置信区间:1.02-10.70,P=0.04)。肺功能的预测误差程度可以忽略不计。

结论

节段计数法可用于预测基于吻合器的胸腔镜肺段切除术后的肺功能。肺段切除术很少导致肺功能和体积值低于预测值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a56d/9081460/6a1cacb687a4/atcs-28-121-g001.jpg

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