Clinical Analysis Of Thoracoscopic Pulmonary Segmentectomy And Pulmonary Lobectomy In Treatment Of Early-stage Non-small Cell Lung Cancer

Objective:Video-assisted thoracic surgery(VATS)has been widely recognized and applied in the treatment of early-stage non-small cell lung cancer,but the specific operation method is stll controversial.The aim of this study was to investigate the clinical effects of thoracoscopic pulmonary segmentectomy and pulmonary lobectomy in treatment of early-stage non-small cell lung cancer.Methods :Clinical data of 84 patients with early-stage non-small cell lung cancertreated in No.2 People's Hospital of Fuyang City from January 2014 to January 2016 were retrospectively analyzed.Respectively,they got the segmentectomy under VATS(36 cases)and lobectomy under VATS(48 cases).The operation time,the intraoperative blood loss,the number of lymph nodes removed,the chest The drainage volume from 24 to 48 hours,the retention time of intrathoracic drain,the hospital-stay-time,the postoperative complications,the changes in lung function,and the postoperative survival rate were compared between the two groups.Results:Patients' clinical characteristics were comparable in both groups,and the operations of patients of two groups were successfully operated,no perioperative death,the operation time of segmentectomy group and lobectomy group was[(167.36±15.96)min VS.(151.31±19.07)min,p<0.001],and the difference showed statistical significance.There was no significant difference in the intraoperative blood loss[(164.31 ± 72.43)ml VS.(187.71 ± 110.97)ml,p=0.247] ? the number of the resected lymph nodes [(11.64±2.67)VS.(12.79±2.71),p=0.055].the difference in the chest drainage volume from 24 to 48 hours [(143.19±55.32)ml VS.(165.00±32.42)ml,p=0.040]? the retention time of intrathoracic drain [(4.11±0.85)d VS.(4.77±0.95)d,p=0.002] ? hospital-stay-time [(6.83 ± 1.36)d VS.(8.02 ± 1.21)d,p <0.001]showed statistical significance.The incidence of postoperative complications of segmentectomy group and lobectomy group was 11.1% and 14.6% respectively,and they had no statistically significant(p=0.751).The decreased percentage of lung function index FEV1 and FVC six months after operation was lower in pulmonary segment group than pulmonary lobe group,the differences were statistically significant(p<0.05).A total of 81 patients were followed up(35 cases were followed up in segmentectomy group and 46 cases in the lobectomy group).1 cases were missed in segmentectomy group and 2 cases in the lobectomy group.The overall follow-up rate was 96.4%.The mean follow-up time was 27.7 months in the segmentectomy group and 28.2months in the lobectomy group.And no tumor-related deaths in either group.Conclusion: The thoracoscopic pulmonary segmentectomy and pulmonary lobectomy have similar clinical effects on treating the early-stage non-small cell lung cancer.However,thoracoscopic pulmonary segmentectomy can maximumretain the healthy lung tissues,and it also has advantages such as less chest drainage volume,short retention time of intrathoracic drain,short hospital-stay-time.It can provide a more minimally invasive surgical procedure for treatment of early-stage lung cancer.