Retrospective Study Of Sub-pulmonary Lobectomy And Pulmonary Lobectomy

Objective:Though a retrospective analysis of clinical data on the comparison of sub-lobectomy and pulmonary lobectomy, characteristics of clinical data are summarized for the two-kind surgical procedures, to provide the references to the patients with peripheral non-small-cell lung cancer(NSCLC) nodule,pulmonary operation opportunities and dependence to the patients with preoperative comorbidities, older age,or not suitable for lobectomy and so on,and sub-pulmonary lobectomy can not only retain more pulmonary function but also reduce the postoperative complications and increase reoperation opportunity in the future. Methods:This study based on the patients in Dalian Central Hospital from July 2011.8 to 2014.8, a total of 70 cases of patients with stage IA Peripheral non-small cell lung cancer, male 24 cases,female 46 cases,Tumor diameter is ≤ 3 cm, including pure GGO, mixed GGO, and solid nodules.including 32 cases of lobectomy,Male 10 cases, female 22 cases, average age is 57.8 years old, and 38 cases of sub-lobectomy including 4 cases of segmental resection of lung,Male 14 cases, female 24 cases, average age is 62.9 years old.Retrospective analysis was studied on them about the age,gender, operation procedure,tumor location in lobe, pathological stage, pleural invasion,operation time, introoperation blood loss, recovery time after operation,number of lymph node dissection,chest tube drainage time, hospitalization time,FEV1%,combination dieases(hypertension, diabetes, coronary heart disease, stroke, COPD, renal dysfunction, multiple primary cancers, etc),complications(pulmonary infection, ventilator assisted, pleural effusion, air leakage of pleural, heart failure, arrhythmia, high blood sugar, etc), follow-up time, and recurrence,so as to compare these variables retrospectively and systemically. Results: In the two groups of excision, age has statistically significant difference(P=0.017), age of sublobar resection group > lobectomy group; In tumor size, there is no significant difference(P=0.119);In hospitalization time,follow-up time,number of lymph node metastasis,no statistically significant differences(P>0.05); while on operation time,blood loss,recovery time,FEV1%,number of lymph node,duration time of chest tube, there is statistically significant difference(P<0.05), sublobar resection group < lobectomy group; In sublobar resection group,there are 38 cases, 27 cases have combination dieases, the incidence is 64.3%, In lobectomy group,there are 32 cases,15 cases have combination dieases, the incidence is 60%, sublobar resection group > lobectomy group, there is significant differences(P=0.04);In Postoperative complications, sublobar resection group 38 cases, there are 12 cases with complications, the incidence rate is 31.6%,In lobectomy resection group 32 cases,3 cases with complications, the incidence is 9.4%, sublobar resection group > lobectomy group, there were significant differences(P=0.024). Conclusion:In this retrospective study,The sub-lobectomy group is older and with low FEV1%, The incidence rates of combined diseases and postoperative complications are high, but the operation time, recovery time, and chest tube drainage time are short significantly, it shows that if the selected patients of sublobar resection in some respects is superior to lobectomy.Because there is still controversy, so the research of large-scale randomized prospective still needs to identify the effects of Sub-pulmonary Lobectomy and pulmonary Lobectomy in treatment of peripheral non small cell lung cancer.