Jiang Hao, Wu Tong, Qie Peng, Wang Huien, Zhang Baoxin
Hao Jiang Department of Thoracic Surgery, Cangzhou People's Hospital, Cangzhou 061000, Hebei, China.
Tong Wu Department of Thoracic Surgery, Cangzhou People's Hospital, Cangzhou 061000, Hebei, China.
Pak J Med Sci. 2024 Sep;40(8):1644-1650. doi: 10.12669/pjms.40.8.9124.
To compare and analyze the clinical effects of thoracoscopic lobectomy and segmentectomy in stage I non-small cell lung cancer (NSCLC).
This was a retrospective study. Eighty patients with stage I NSCLC treated in Cangzhou People's Hospital from December 2019 to January 2022 were randomly divided into the segmentectomy group and lobectomy group, with 40 cases in each group. Further comparative analysis was carried out focusing on perioperative indexes, maximum ventilation volume (MVV), forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), VAS score of postoperative pain and complications.
There was no significant difference in the number of dissected lymph nodes and extubation time between the two groups (p>0.05). The operation time was longer, while intraoperative blood loss was less and the stay of stay in hospital was shorter in the segmentectomy group significantly than those in the lobectomy group (p<0.05). Furthermore, no significant difference was observed in MVV%, FVC% and FEV1% between the two groups before operation (p>0.05). Meanwhile, the segmentectomy group had evidently lower VAS scores at 1 d, 3 d and 5 d postoperatively than those in the lobectomy group (p<0.05). Besides, there was a much lower total incidence of complications in the segmentectomy group than that in the lobectomy group (p<0.05).
Compared with lobectomy, thoracoscopic segmentectomy is more effective in the treatment of stage I NSCLC, with less bleeding and mild pain, which can alleviate pulmonary function injury and reduce postoperative complications that is conducive to the improved prognosis of patients.
比较和分析胸腔镜肺叶切除术与肺段切除术治疗Ⅰ期非小细胞肺癌(NSCLC)的临床效果。
本研究为回顾性研究。选取2019年12月至2022年1月在沧州市人民医院接受治疗的80例Ⅰ期NSCLC患者,随机分为肺段切除术组和肺叶切除术组,每组40例。重点对围手术期指标、最大通气量(MVV)、用力肺活量(FVC)、第1秒用力呼气量(FEV1)、术后疼痛视觉模拟评分(VAS)及并发症进行进一步的对比分析。
两组清扫淋巴结数量及拔管时间比较,差异无统计学意义(p>0.05)。肺段切除术组手术时间较长,术中出血量较少,住院时间明显短于肺叶切除术组(p<0.05)。此外,两组术前MVV%、FVC%及FEV1%比较,差异无统计学意义(p>0.05)。同时,肺段切除术组术后1 d、3 d及5 d的VAS评分明显低于肺叶切除术组(p<0.05)。此外,肺段切除术组并发症总发生率明显低于肺叶切除术组(p<0.05)。
与肺叶切除术相比,胸腔镜肺段切除术治疗Ⅰ期NSCLC效果更佳,出血少、疼痛轻,可减轻肺功能损伤,减少术后并发症,有利于改善患者预后。