Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
J Cardiothorac Surg. 2022 May 7;17(1):107. doi: 10.1186/s13019-022-01853-3.
Segmentectomy has been reported as an alternative to lobectomy for small-sized NSCLC without detriment to survival. The long-term benefits of segmentectomy over lobectomy on pulmonary function have not been firmly established. This meta-analysis aims to compare postoperative changes in pulmonary function in NSCLC patients undergoing segmentectomy or lobectomy.
Medline, Embase, Web of Science and Scopus were searched through March 2021. Statistical comparisons were made when appropriate.
Fourteen studies (2412 participants) out of 324 citations were included in this study. All selected studies were high quality, as indicated by the Newcastle-Ottawa scale for assessing the risk of bias. Clinical outcomes were compared between segmentectomy and lobectomy. ΔFEV1 [10 studies, P < 0.01, WMD = 0.40 (0.29, 0.51)], ΔFVC [4 studies, P < 0.01, WMD = 0.16 (0.07, 0.24)], ΔFVC% [4 studies, P < 0.01, WMD = 4.05 (2.32, 5.79)], ΔFEV1/FVC [2 studies, P < 0.01, WMD = 1.99 (0.90, 3.08)], and ΔDLCO [3 studies, P < 0.01, WMD = 1.30 (0.69, 1.90)] were significantly lower in the segmentectomy group than in the lobectomy group. Subgroup analysis showed that in stage IA patients, the ΔFEV1% [3 studies, P < 0.01, WMD = 0.26 (0.07, 0.46)] was significantly lower in the segmentectomy group. The ΔDLCO% and ΔMVV% were incomparable.
Segmentectomy preserves more lung function than lobectomy. There were significantly smaller decreases in FEV1, FVC, FVC%, FEV1/FVC and DLCO in the segmentectomy group than in the lobectomy group.
对于无生存损害的小尺寸 NSCLC，段切除术已被报道为肺叶切除术的替代方法。段切除术相对于肺叶切除术对肺功能的长期益处尚未得到明确证实。本荟萃分析旨在比较接受段切除术或肺叶切除术的 NSCLC 患者术后肺功能的变化。
通过 2021 年 3 月对 Medline、Embase、Web of Science 和 Scopus 进行了检索。当合适时进行了统计学比较。
在 324 篇引文中有 14 项研究（2412 名参与者）被纳入本研究。所有入选研究均为高质量研究，如纽卡斯尔-渥太华量表评估偏倚风险所示。对段切除术和肺叶切除术的临床结果进行了比较。ΔFEV1[10 项研究，P<0.01，WMD=0.40（0.29，0.51）]、ΔFVC[4 项研究，P<0.01，WMD=0.16（0.07，0.24）]、ΔFVC%[4 项研究，P<0.01，WMD=4.05（2.32，5.79）]、ΔFEV1/FVC[2 项研究，P<0.01，WMD=1.99（0.90，3.08）]和 ΔDLCO[3 项研究，P<0.01，WMD=1.30（0.69，1.90）]在段切除术组中明显低于肺叶切除术组。亚组分析表明，在 IA 期患者中，段切除术组的 ΔFEV1%[3 项研究，P<0.01，WMD=0.26（0.07，0.46）]明显降低。ΔDLCO%和 ΔMVV%不可比。
与肺叶切除术相比，段切除术保留了更多的肺功能。段切除术组的 FEV1、FVC、FVC%、FEV1/FVC 和 DLCO 下降幅度明显小于肺叶切除术组。
