Comparing Clinical Value Of Single-port Video-assisted Thoracoscopic Surgery Lobectomy And Segmentectomy In Elderly Patients With Non-small Cell Lung Cancer

Objective To explore and analyze Clinical Value of Single-port Video-assisted Thoracoscopic Surgery Lobectomy and Segmentectomy in Elderly Patients with Non-small Cell Lung Cancer(NSCLC).Methods In this retrospective observational study,the outcomes of 550 consecutive patients who had undergone single-port video-assisted thoracoscopic surgery(SP VATS)anatomic segmentectomy or lobectomy for NSCLC from April 2014 to June 2016 were examined.The preoperative clinical general condition,preoperative complications,lung function,operation time,intraoperative blood loss,numbers of dissected lymph nodes and mediastinal nodal stations,postoperative pathological files,postoperative drainage volume and duration,duration of postoperative hospital stay,costs,postoperative complications,local recurrence,and survival were compared between elderly and non-elderly Patients with NSCLC undergone SP VATS anatomic segmentectomy or lobectomy,and SP VATS anatomic segmentectomy and lobectomy in elderly patients with NSCLC for exploring clinical value,which were grouped according to age and operation method and meeting the inclusive and exclusive criteria.Results The preoperative clinical general condition,preoperative complications,lung function were not significant difference(P>0.05)between SP VATS anatomic segmentectomy and lobectomy in elderly patients with NSCLC.Aiameter of tumor and the number of invasive adenocarcinoma and squamous-cell carcinoma in elderly patients with NSCLC undergone SP VATS lobectomy was more than segmentectomy(P<0.05).numbers of dissected lymph nodes and mediastinal nodal stations of SP VATS lobectomy in elderly patients with NSCLC were more than segmentectomy(P<0.05),one was(7.61±0.21)and(20.39±0.97),the other was(5.60±0.35)and(15.40±2.64).But there was not significant difference between two groups of SP VATS lobectomy and anatomic segmentectomy in operation time((194.81±8.09)min vs(211.93±17.41)min),intraoperative blood loss((74.55±6.19)ml vs(94.67±18.62)ml),postoperative drainage volume((1150.15±140.02)ml vs(853.53±177.04)ml)and duration((7.00±1.31)d vs(5.00±0.74)d),duration of postoperative hospital stay((3.18±1.32)d vs(5.04±1.30)d),costs((70.06±5.23)thousands yuan vs(61.20±5.22)thousands yuan)or postoperative complications(5.97% vs 20.00%)(P>0.05).The group of SP VATS anatomic segmentectomy found more postoperative atrial fibrillation and the vein thrombosis of lower limbs(P<0.05).The follow-up studies with outpatient and telephone way for 417 cases of postoperative patients,which duration was 94 to 815 d(mean 403.5 d),without local recurrence of the tumor and tumor death until the last follow-up time.Conclusion SP VATS segmentectomy is as safe and effective as SP VATS lobectomy in elderly patients,who fit to undergo SP VATS segmentectomy seem to get as same clinical value as SP VATS lobectomy.The surgical option is recommend.