目的:对比电视胸腔镜解剖性肺段切除术、肺叶切除术对磨玻璃结节样早期非小细胞肺癌(Non-small cell lung cancer,NSCLC)的短期肺功能的影响.方法:选取 2020 年1 月～2024 年6 月赣州市兴国县人民医院收治的62 例磨玻璃结节样早期NSCLC患者作为研究对象,根据入院顺序单双数编号分为肺段组和肺叶组,各 31 例.肺段组开展电视胸腔镜解剖性肺段切除术治疗,肺叶组开展肺叶切除术治疗.术后门诊随访 3 m.对比肺段组、肺叶组手术相关指标、肺功能、炎症反应,统计术后并发症情况.结果:肺段组术中出血量、术后胸腔引流量明显低于肺叶组(P＜0.05),引流管留置时间、住院时间明显少于肺叶组(P＜0.05),手术时长明显大于肺叶组(P＜0.05),两组清扫淋巴结数无明显区别(P＞0.05).术后 3 d,两组肿瘤坏死因子-α、白介素-6、C反应蛋白水平均明显上升(P＜0.05),但肺段组均明显低于肺叶组(P＜0.05);术后 3 m,两组第 1 秒用力呼气容积(Forced expiratory volume in the first second,FEV1)、用力肺活量(Forced vital capacity,FVC)、最大分钟通气量(Maximal voluntary ventilation,MVV)均明显下降,但肺段组均明显高于肺叶组(P＜0.05);两组术后并发症、复发率无明显差异(P＞0.05).结论:相较于肺叶切除术,电视胸腔镜解剖性肺段切除术对磨玻璃结节样早期NSCLC治疗效果更显著,不仅减少术中出血量,缩短引住院时间,同时对患者短期肺功能影响较小.
Effects of video-assisted thoracoscopic anatomic pulmonary segmentectomy and lobectomy on short-term lung function in patients with ground glass nodule-like early NSCLC
Objective:To compare the effects of video-assisted thoracoscopic anatomic pulmonary segmentectomy and lobectomy on short-term lung function in patients with ground glass nodule-like early non-small cell lung cancer(NSCLC).Methods:A total of 62 patients with ground glass nodule-like early NSCLC who were admitted to Xingguo People's Hospital in Ganzhou from January 2020 to June 2024 were selected as the study subjects.According to the odd and even numbers of admission order,they were assigned to segmentectomy group and lobectomy group,31 cases in each group.The segmentectomy group underwent video-assisted thoracoscopic anatomic pulmonary segmentectomy and the lobectomy group underwent pulmonary lobectomy.All patients completed 3 months of postoperative outpatient follow-up.Surgery related indicators,lung function and inflammatory response were compared between segmentectomy group and lobectomy group.Postoperative complications were statistically analyzed.Results:The intraoperative blood loss and postoperative thoracic drainage volume of segmentectomy group were significantly smaller than those of lobectomy group(P<0.05).The drainage tube indwelling time and hospitalization time were significantly shorter than those of lobectomy group(P<0.05).The surgery time was significantly longer than that of lobectomy group(P<0.05).There was no significant difference in the number of lymph nodes dissected between the two groups(P>0.05).The levels of tumor necrosis factor-α,interleukin-6 and C-reactive protein in the two groups on day 3 after surgery were higher than preoperative levels(P<0.05).Moreover,the levels in segmentectomy group were lower than those in the lobectomy group(P<0.05).Three months after surgery,forced expiratory volume in the first second(FEV1),forced vital capacity(FVC)and maximum minute ventilation(MVV)of both groups decreased significantly.However,FEV1,FVC and MVV of the segmentectomy group were significantly higher than those of the lobectomy group(P<0.05).There were no significant differences in postoperative complications and recurrence rates between the two groups(P>0.05).Conclusion:Compared to lobectomy,video-assisted thoracoscopic anatomic pulmonary segmentectomy is more effective in treating ground glass nodule-like early NSCLC.It can reduce intraoperative blood loss and shorten hospitalization time,with less influence on short-term lung function.
Video-assisted thoracoscopic anatomic pulmonary segmentectomyLobectomyGround glass noduleEarlyNon-small cell lung cancer
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