Clinical Study Of Thoracoscopic Sublobar Resection For The Treatment Of Stage IA Non-small Cell Lung Cancer

ObjectiveTo explore the thoracoscopic sublobar resection for the treatment of stage IA non-small cell lung cancer perioperative clinical effect,providing clinical basis for surgical treatment of patients with stage IA non-small cell lung cancer.MethodsRetrospectively analyzed the clinical data of 120 patients with IA stage non-small cell lung cancer undergoing thoracoscopic lobectomy and thoracoscopic sublobar resection from January 2013 to April 2017 in the Department of Cardiothoracic surgery,5th affiliated Hospital of Zhengzhou University.According to the difference of surgical procedure,56 cases were divided into the thoracoscopic sublobar resection group(26 males,30 females),45 cases underwent pulmonary wedge resection,11 cases underwent pulmonary segmental resection,64 cases of thoracoscopic lobectomy group(29 males and 35 females).The data of perioperative period were analyzed and compared between the two groups,including: age,operation time,intraoperative bleeding volume,postoperative bed rest time,drainage time of thoracic tube,drainage of pleural effusion on the first day after operation,postoperative hospitalization time,the number of complications before operation,and incidence of postoperative complications.ResultsAll the patients were discharged smoothly and no perioperative death was found.There was no significant difference between the two groups in terms of gender difference(P = 0.605).Thoracoscopic sublobar resection group: the mean age was 62.82 ±7.17 years,the operative time was 120.54 ±14.43 min,the intraoperative bleeding was 150.09 ±31.31 ml,the postoperative bed rest time was 2.07 ±0.68 d,the drainage time was 3.07 ±0.99 days,the volume of pleural effusion was 144.11 ±45.03 ml on the first day of operation,the postoperative hospitalization time was 4.20 ±0.96 d.There were 19 cases of complications before operation and the incidence of postoperative complications was 14.30%.Thoracoscopic lobectomy group: the mean age was 57.11±6.20 years,the operative time was 159.02 ±20.99 min,the intraoperative bleeding was 198.88 ±30.49 ml,the postoperative bed rest time was 2.52 ±0.69 days,the drainage time was 3.63 ±0.85 days,the volume of pleural effusion was 152.72 ±37.02 ml on the first day after operation,the hospitalization time was 4.44 ±1.08 days.There were 10 cases of complications before operation and the incidence of postoperative complications was 17.20%.There was no significant difference in the incidence of postoperative complications,drainage of pleural effusion and postoperative hospitalization time between thoracoscopic sublobar resection group and thoracoscopic lobectomy group(P > 0.05).The patients in thoracoscopic sublobar resection group were older than those in thoracoscopic lobectomy group.There were more complications before operation,shorter operative time,less blood loss during operation,shorter bed-rest time after operation,and shorter drainage time of thoracic canal after operation.The difference was statistically significant(P < 0.05).ConclusionsBoth thoracoscopic sublobar resection and lobectomy for stage IA non-small cell lung cancer perioperative period are safe and effective.Sublobar resection has less trauma,less bleeding,shorter postoperative bed time and more conducive to the rapid recovery of patients after surgery.Thoracoscopic sublobar resection for more preoperative underlying diseases or older patients have more advantages,it is worth popularizing in clinical.