Effects of uniportal thoracoscopic pulmonary segmentectomy and lobectomy on patients with early-stage non-small-cell lung cancer and risk factors of postoperative complications.

OBJECTIVE

To determine the effects of uniportal thoracoscopic pulmonary segmentectomy and lobectomy on patients with early-stage non-small-cell lung cancer (ES-NSCLC) and risk factors of postoperative complications.

METHODS

The clinical data of 97 patients with early lung cancer treated in Mingguang People's Hospital between October 2019 and December 2021 were retrospectively analyzed. A total of 45 patients who underwent pulmonary segmentectomy were assigned to the observation group. The remaining 52 patients who underwent lobectomy were assigned to the control group. The perioperative indexes of the two groups were compared, including operation time, intraoperative blood loss, intraoperative lymph node dissection, postoperative indwelling time of drainage tube and postoperative drainage volume. The treatment cost and hospitalization time of the two groups were compared. The changes of inflammatory indexes including C-reactive protein (CRP), interleukin (IL)-1β, IL-6, and tumour necrosis factor (TNF)-α before and after treatment were compared between the two groups. The changes of forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were compared between the two groups. The incidence of postoperative complications in the two groups was counted. Logistic regression was conducted for analyzing the risk factors of postoperative complications.

RESULTS

The two groups were similar in operation time, intraoperative blood loss, and number of intraoperative lymph node dissected (all P>0.05). The observation group experienced a significantly shorter postoperative indwelling time of drainage tube and less postoperative drainage volume than the control group after surgery (P<0.05). The observation group presented significantly lower CRP, IL-1β, IL-6, and TNF-α levels than the control group (P<0.001). The observation group presented significantly higher FEV1 and FVC levels than the control group at 3 months after operation (P<0.001). The treatment cost of the two groups was not greatly different (P>0.05), but the observation group experienced a significantly shorter hospitalization time than the control group (P<0.001). The two groups were similar in the incidence of complications (P>0.05). According to multivariate logistics regression analysis, age, operation time, and number of lymph nodes dissected were independent risk factors for postoperative complications (P<0.05).

CONCLUSION

To sum up, for patients with early LC, pulmonary segmentectomy is significantly more effective than lobectomy in terms of pulmonary function and inflammatory response, and age, operation time and number of lymph node dissected during operation are independent risk factors affecting postoperative complications.