A Comparative Study Of The Efficacy Of Da Vinci Robot-assisted Lobectomy And Segmentectomy For Stage ⅠA Non-small Cell Lung Cancer

Objective: To analyze the safety and efficacy of da Vinci robotic-assisted lobectomy and segmentectomy for the treatment of stage ⅠA non-small cell lung cancer ≤2 cm in diameter.Methods:Retrospective analysis of 174 patients who underwent da Vinci robotic-assisted lobectomy and segmentectomy for stage ⅠA non-small cell lung cancer ≤2 cm in diameter and pathologically confirmed at the General Hospital of Northern Theater Command from January 2018 to December 2021.The patients were divided into two groups according to the surgical procedure: 82 patients in the segmentectomy group and 92 patients in the lobectomy group.Results: All enrolled patients were 70 males and 104 females with a mean age of(57.77±10.22)years.There were no statistically significant differences between the two groups in clinical data such as age,gender,smoking history,underlying disease,pathological type,tumor diameter,serum albumin,FEV1,MVV,operative time,intraoperative blood loss,postoperative 24 h drainage,and overall postoperative complications.Intraoperative correlation data showed that the number of lymph node dissection groups in the segmentectomy group [(4.82 ± 1.18)group vs.(5.50 ± 1.48)group,P = 0.001],the number of lymph nodes dissected [(12.71±3.92)vs.(17.97±7.84),P<0.001],the postoperative 72 h drainage [(564.39 ± 227.29)ml vs.(659.95 ± 326.67)ml,P = 0.028] were less,number of days of chest drainage [(5.50 ± 3.94)days vs.(7.73± 5.02)days,P = 0.001] and days of postoperative hospitalization [(7.48 ± 4.18)days vs.(9.77 ± 5.58)days,P = 0.003] were less than the lobectomy group,and the differences were all statistically significant.Univariate and multifactorial logistic regression analysis showed that segmentectomy was a protective factor for days of chest drainage beyond one week.There were no cases of intermediate open heart and perioperative death in both groups,and the median follow-up time after surgery was 27 months,with a follow-up rate of 100.0%.The recurrence-free survival rates were 97.6% and 94.5% in the segmentectomy and lobectomy groups,respectively,with no statistically significant difference(P=0.944).Conclusion:In conclusion,the long-term prognosis of patients with stage ⅠA NSCLC ≤2cm in diameter treated with da Vinci robot-assisted segmentectomy and lobectomy is similar.However,compared with lobectomy,segmentectomy can significantly reduce postoperative chest drainage and drainage time,which in turn reduces the length of hospital stay,is more conducive to rapid postoperative recovery,and reduces the psychological burden of patients.