The Effects On Pulmonary Function For NSCLC Patients After VATS Lobectomy,VATS Anatomic Segmentectomy, Or Open Thoractomy And Correlation Factors Analysis

Background Lung cancer is one of the highest mobidity and mortality manlignancies in the world. Surgery is the preference for non-small cell lung cancer. Minimally invasive is the trend of surgery. Video-assisted thoracoscopic surgery is the important way to realize minimally invasive surgery, which means that lung lobectomy, pulmonary vascular ligation, closing bronchial with staple and resecting mediastinal and hilar lymph nodes were made without rib spreading. Compared with open thoracotomy, VATS lobectomy and segmentectomy affect less on pulmonary function, alleviate pain and make patients recover faster. But there is no report which describes in the early stage after surgery how well pulmonary function recovers. The aim of this study is to investigate in the early postoperative stage at which level the pulmonary function is and compare the effects on pulmonary function after VATS lobectomy,VATS segmentectomy or open thoracotomy and explore the correlation factors which influence the recovery of pulmonary function.Methods The pulmonary function data of patients were collected from September 2015 to February 2016 in Department of Thoracic Surgery, Cancer Hospital Chinese Academy of Medical Sciences. Divide patients into three groups according to operation methods and name them as VATS segmentectomy,VATS lobectomy and open thoracotomy. Test their pulmonary function at the time of one day before surgery, three days after surgery and three months after surgery. We make statistical analysis with SPSS 20.0 version in the way of single factor analysis of variance and correlation analysis and polyol regression analysis.Results We compared pulmonary function collected at the time of 3 days after surgery of 3 groups and found that there is big difference in FVC, FVC%, FEV1, FEV1%, PEF, MVV, TLCO and TLCO%(P values are as follows:0.033,0.042,0.029,0.045,0.039, 0.021,0.018,0.024).The results of the comparison at the time of 3 months show that the data of VATS segmentectomy group is better than VATS lobectomy group and the pulmonary function level of VATS lobectomy is better than the open thoracotomy group in FVC, FVC%, FEV1, FEV1%, PEF, MVV, TLCO and TLCO%(P values are as follows:0.019,0.024,0.044,0.021,0.037,0.029,0.045,0.017). The results of correlation analysis by using the data of pulmonary function at the time of 3 days after surgery show that related factors influencing the ventilation function recovery are amount of bleeding, operation, pain, operation time and basic lung function. Only pain degree, basic lung function and operation have correlation with the recovery of ventilation function by polyol regression analysis. There are correlations between amount of bleeding, operation, pain, operation time, basic lung function and diffusion function recovery in the early postoperative stage. Only amount of bleeding has correlation with the recovery of diffusion function by polyol regression analysis. There are correlations between amount of bleeding, operation, pain, operation time, basic lung function, drainage days and ventilation function recovery after 3 months of surgery. Operation has correlation with the recovery of ventilation function by polyol regression analysis. There are correlations between amount of bleeding, operation, pain, basic lung function and diffusion function recovery at the time of 3 months after surgery. Only amount of bleeding has correlation with the recovery of diffusion function by polyol regression analysis.Conclusion The difference of effects on pulmonary function was significant among different groups no matter at the time of 3 days or 3 months after surgery. Patients’lung function in the VATS segmentectomy group recovered better than the VATS lobectomy group. The data of VATS lobectomy group is better than open thoracotomy group. In the early postoperative stage, operation, the amount of bleeding, basic lung function and pain degree have correlations with the recovery of lung function by multiplicity factor analysis. And operation and the amount of bleeding have correlations with the recovery of lung function by multiplicity factor analysis.