Cao Kexin, Zhu Jian, Zheng Jianan, Wei Ke, Li Zhihua, Chen Zhijun, Chen Liang, Wu Weibing
Department of Thoracic Surgery, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453600, People's Republic of China.
Department of Thoracic Cardiovascular Surgery, General Hospital of Central Theater Command of the People's Liberation Army, Wuhan, 430070, People's Republic of China.
BMC Surg. 2024 Dec 21;24(1):409. doi: 10.1186/s12893-024-02719-2.
Thoracoscopic segmentectomy is the main surgical method for the treatment of earlylung cancer. With the promotion of technology and increasingly accurate criteria for lung subsegments, lung nodules with complex positions involving intersegmental and multisegments have become technical bottlenecks. This study aimed to verify whether seeking anatomical conditions for creating a fissure by tunneling techniques with precise resection of lung segments could solve this bottleneck problem.
The clinical data of patients with lung nodules ≤ 2 cm located in the complex position in the Department of Thoracic Surgery of Jiangsu Provincial People's Hospital from January 2019 to August 2023 were collected. Date analyzed the characteristics of patients who underwent seeking anatomical conditions for creating a fissure by tunneling techniques with precise resection of lung segments (segment group) at complex setting and compared the surgical outcomes and complications between these lobectomy patients (lobectomy group) at similar locations.
A total of 22 patients were included segment group and 47 patients were included lobectomy group. Except for the depth ratio or tumor size or consolidation tumor ratio (CTR), there were no significant differences in the other baseline data between the two groups. All patients in segment group received a satisfactory surgical margin. Compared to the lobectomy group, surgical outcomes were better in segment group (p < 0.05 for postoperative hospital stay and the counts of resected subsegments).
Seeking anatomical conditions for creating a fissure by tunneling techniques is a promising technique for performing precise resection of lung segments with a safe resection margin for patients with lung nodules at complex positions involving multiple segments. It can be used as a precise resection of lung segments technique.
胸腔镜肺段切除术是早期肺癌的主要手术治疗方法。随着技术的推广以及肺亚段划分标准日益精确，位置复杂、累及肺段间和多个肺段的肺结节已成为技术瓶颈。本研究旨在验证通过隧道技术寻找创建肺裂的解剖条件并精确切除肺段是否能解决这一瓶颈问题。
收集2019年1月至2023年8月江苏省人民医院胸外科收治的位于复杂位置、直径≤2 cm的肺结节患者的临床资料。分析在复杂情况下采用隧道技术寻找创建肺裂的解剖条件并精确切除肺段的患者（肺段组）的特征，并比较这些在相似位置行肺叶切除术的患者（肺叶切除组）的手术效果及并发症。
肺段组共纳入22例患者，肺叶切除组共纳入47例患者。两组间除深度比、肿瘤大小或实性肿瘤比（CTR）外，其他基线数据无显著差异。肺段组所有患者的手术切缘均满意。与肺叶切除组相比，肺段组的手术效果更好（术后住院时间和切除亚段数量p<0.05）。
通过隧道技术寻找创建肺裂的解剖条件是一种有前景的技术，可为累及多个肺段的复杂位置肺结节患者提供安全切缘并精确切除肺段。它可作为一种肺段精确切除技术。
