Application of the anatomical partial lobectomy based on"watershed analysis"in the treatment of early-stage peripheral lung cancer
Objective To investigate the clinical eficacy of the anatomical partial lobectomy based on"watershed analysis"in the treatment of early-stage peripheral lung cancer.Methods A prospective,randomized and controlled study was performed on 128 patients with early-stage peripheral lung cancer pa-tients admitted to our hospital from May 2022 and May 2023.Patients were randomly divided into segmen-tal pneumonectomy group and segmental pneumonectomy based on"watershed analysis"group by the enve-lope method before surgery.The segmental group underwent segmentectomy while the watershed group only cut the target artery or vein while preserving segmental bronchus.The perioperative clinical data were com-pared between the two groups and the significant differences between two groups were determined by inde-pendent-sample T test.Results There were no statistically significant differences in gender,age,ASA grading[American Society of Anesthesiologists(ASA)Physical Status Classification System],presence or absence of underlying diseases,nodule characteristics,and follow-up time,postoperative pathology,maxi-mum tumor diameter,pathological staging,and surgical margin between two groups(x2=0.04,t=-0.09,x2=0.17,x2=0.04,x2=0.00,t=-0.98,x2=2.02,t=-1.19,x2=2.02,t=-2.48,P＞0.05).The watershed group was superior to the segment group in terms of surgical time and postopera-tive hospitalization days[(107.1±35.7)vs.(143.4±38.6)ml,(4.8±1.6)vs.(5.2±1.8)d,P＞0.05],but the difference was not statistically significant(P＞0.05).The watershed group had lower bleeding volume,less number of lymph nodes,and shorter postoperative drainage time than the segment group[(17.7±9.2)vs.(27.3±22.2)ml,(2.1±0.7)vs.(2.3±0.9)min,(3.1±2.1)vs.(5.5± 3.8),P＜0.05],with a statistically significant difference(P＜0.05).Conclusion The anatomical par-tial lobectomy based on"watershed analysis"in the treatment of early-stage peripheral lung cancer is safe and feasible,which has more advantages in shortening the operation time,reducing intraoperative bleeding.
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