Wang Gaoxiang, Chen Zhengwei, Wu Mingsheng, Li Tian, Sun Xiaohui, Xu Meiqing, Xie Mingran
Department of Thoracic Surgery, The First Affiliated Hospital of University of Science and Technology of China, Hefei 230001, China.
Zhongguo Fei Ai Za Zhi. 2024 Feb 20;27(2):102-108. doi: 10.3779/j.issn.1009-3419.2023.102.48.
Cough is one of the main complications after pulmonary surgery, which seriously affects the postoperative quality of life. Preserving the pulmonary branch of vagus nerve may reduce the incidence of postoperative cough. Therefore, the aim of this study was to investigate whether preserving the pulmonary branch of the vagus nerve could reduce the incidence of postoperative chronic cough in patients with stage I peripheral lung adenocarcinoma.
A total of 125 patients who underwent single-port thoracoscopic radical resection for lung cancer in the Department of Thoracic Surgery, The First Affiliated Hospital of University of Science and Technology of China from June 2022 to June 2023 were retrospectively selected, and divided into two groups according to whether the vagopulmonary branch was preserved during the operation, namely, the vagopulmonary branch group (n=61) and the traditional group (n=64). The general clinical data, perioperative conditions, lymph node dissection, Mandarin Chinese version of The Leicester Cough Questionnaire (LCQ-MC) scores before and 8 weeks after operation were recorded in the two groups. Both the two groups were divided into tamponade group and non-tamponade group according to whether autologous fat or gelatin sponge was tamponade after lymph node dissection. LCQ-MC scores and postoperative chronic cough of both groups were calculated.
The LCQ-MC score of the traditional group was significantly lower than that of the vagopulmonary branch group in physiological, psychological, social and total scores at 8 weeks after surgery, and the difference was statistically significant (P<0.05). There were more cough patients in the traditional group than the vagopulmonary branch group at 8 weeks after surgery, with significant difference (P=0.006). Subgroup analysis was conducted separately for the vagopulmonary branch group and the traditional group. Among the patients in the vagopulmonary branch group and the traditional group, the LCQ-MC scores of the non-tamponade group 8 weeks after surgery were lower than those of the tamponade group (P<0.05). There were more patients with cough in the group 8 weeks after surgery than in the tamponade group (P=0.001, P=0.024).
For patients with stage I peripheral lung adenocarcinoma, the preservation of the pulmonary branch of vagus nerve is safe and effective, which can reduce the incidence of postoperative chronic cough and improve the postoperative quality of life of the patients.
咳嗽是肺手术后的主要并发症之一，严重影响术后生活质量。保留迷走神经肺支可能降低术后咳嗽的发生率。因此，本研究旨在探讨保留迷走神经肺支是否能降低Ⅰ期周围型肺腺癌患者术后慢性咳嗽的发生率。
回顾性选取2022年6月至2023年6月在中国科学技术大学附属第一医院胸外科行单孔胸腔镜肺癌根治术的125例患者，根据术中是否保留迷走神经肺支分为两组，即迷走神经肺支组（n=61）和传统组（n=64）。记录两组患者的一般临床资料、围手术期情况、淋巴结清扫情况、术前及术后8周中文版莱斯特咳嗽问卷（LCQ-MC）评分。两组均根据淋巴结清扫后是否用自体脂肪或明胶海绵填塞分为填塞组和非填塞组。计算两组的LCQ-MC评分及术后慢性咳嗽情况。
术后8周，传统组在生理、心理、社会及总分方面的LCQ-MC评分均显著低于迷走神经肺支组，差异有统计学意义（P<0.05）。术后8周，传统组咳嗽患者多于迷走神经肺支组，差异有统计学意义（P=0.006）。分别对迷走神经肺支组和传统组进行亚组分析。迷走神经肺支组和传统组患者中，术后8周非填塞组的LCQ-MC评分低于填塞组（P<0.05）。术后8周该组咳嗽患者多于填塞组（P=0.001，P=0.024）。
对于Ⅰ期周围型肺腺癌患者，保留迷走神经肺支安全有效，可降低术后慢性咳嗽的发生率，提高患者术后生活质量。
