单孔与楔形切除术治疗外周型小尺寸非小细胞肺癌患者早期报告结局的比较。
Comparison of early patient-reported outcomes between uniportal thoracoscopic segmentectomy and wedge resection for peripheral small-sized non-small-cell lung cancer.
机构信息
Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, 610041, Sichuan, China.
Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Graduate School, Chengdu Medical college, Chengdu, 610041, Sichuan, China.
出版信息
J Cardiothorac Surg. 2024 Apr 15;19(1):215. doi: 10.1186/s13019-024-02635-9.
BACKGROUND
Analysis of patient-reported outcomes (PROs) offers valuable insights into distinguishing the effects of closely related medical procedures from the patient's perspective. In this study we compared symptom burden in patients undergoing uniportal thoracoscopic segmentectomy and wedge resection for peripheral small-sized non-small cell lung cancer (NSCLC).
METHODS
This study included patients with peripheral NSCLC from an ongoing longitudinal prospective cohort study (CN-PRO-Lung 3) who underwent segmentectomy or wedge resection with tumor diameter ≤ 2 cm and consolidation tumor ratio (CTR) ≤ 0.5. PROs data were collected using the Perioperative Symptom Assessment for Lung Surgery questionnaire pre-operatively, daily post-surgery up to the fourth hospitalization day, and weekly post-discharge up to the fourth week. Propensity score matching and a generalized estimation equation model were employed to compare symptom severity. In addition, short-term clinical outcomes were compared.
RESULTS
In total, data of 286 patients (82.4%) undergoing segmentectomy and 61 patients (17.6%) undergoing wedge resection were extracted from the cohort. No statistically significant differences were found in the proportion of moderate-to-severe symptoms and mean scores for pain, cough, shortness of breath, disturbed sleep, fatigue, drowsiness, and distress during the 4-day postoperative hospitalization or the 4-week post-discharge period before or after matching (all p > 0.05). Compared with segmentectomy, wedge resection showed better short-term clinical outcomes, including shorter operative time (p = 0.001), less intraoperative bleeding (p = 0.046), and lower total hospital costs (p = 0.002).
CONCLUSIONS
The study findings indicate that uniportal thoracoscopic segmentectomy and wedge resection exert similar early postoperative symptom burden in patients with peripheral NSCLC (tumor diameter ≤ 2 cm and CTR ≤ 0.5).
CLINICAL TRIAL REGISTRATION
Not applicable.
背景
分析患者报告的结局（PROs）可以从患者角度提供有价值的见解，有助于区分密切相关的医疗程序的效果。本研究比较了经单端口胸腔镜肺段切除术和楔形切除术治疗外周小尺寸非小细胞肺癌（NSCLC）患者的症状负担。
方法
本研究纳入了一项正在进行的纵向前瞻性队列研究（CN-PRO-Lung 3）中经单端口胸腔镜肺段切除术或楔形切除术治疗的外周性 NSCLC 患者，肿瘤直径≤2cm，实性肿瘤比（CTR）≤0.5。术前使用围手术期肺部手术症状评估问卷（Perioperative Symptom Assessment for Lung Surgery questionnaire）收集 PRO 数据，术后每天至第四次住院日，出院后每周至第四周。采用倾向评分匹配和广义估计方程模型比较症状严重程度。此外，比较了短期临床结局。
结果
共从队列中提取了 286 例（82.4%）行肺段切除术和 61 例（17.6%）行楔形切除术患者的数据。匹配前后，4 天住院期间和出院后 4 周内，中度至重度症状的比例和疼痛、咳嗽、呼吸急促、睡眠障碍、疲劳、困倦和不适的平均评分无统计学差异（均 P>0.05）。与肺段切除术相比，楔形切除术具有更好的短期临床结局，包括更短的手术时间（P=0.001）、术中出血量更少（P=0.046）和总住院费用更低（P=0.002）。
结论
本研究结果表明，对于肿瘤直径≤2cm 和 CTR≤0.5 的外周性 NSCLC 患者，经单端口胸腔镜肺段切除术和楔形切除术的早期术后症状负担相似。
临床试验注册
不适用。
Zotero 插件