The Clinical Efficacy Study Of Thoracoscopic Sublobar Resection In The Treatment Of Early Invasive Non-small Cell Lung Cancer

Objective:To explore the value of thoracoscopic sublobar resection in the treatment of early invasive non-small cell lung cancer.Methods:The clinical data of 215 patients with early invasive non-small cell lung cancer who underwent surgical operation from November 2011 to January 2018 were retrospectively analyzed.The whole group were underwent thoracoscopic surgery,including male 105 cases,accounting for 48.9%,female 110 cases,accounting for51.1%;24-83 years of age,with the average age(61.4±10.8)years;173 cases of stage IA lung cancer(micro invasive lung cancer except),accounting for 80.4%;and stage IB lung cancer in 42 cases,accounting for 19.6%;78 sublobar resection cases(56 cases of wedge resection,22 cases of Segmentectomy resection);137 cases of lobectomy resection.By comparing the perioperative indicators of two operative methods,we evaluated the short-term curative effect of sublobar,by compared the 1 years,2 years and 3 years'disease-free survival rate of two surgical methods,and evaluated the short-term and medium-term prognosis of sublobar.Results:(1)215 patients underwent thoracoscopic surgery,including 78 cases of sublobar resection,22 cases of Segmentectomy resection,56 cases of wedge resection,and 137 cases of lobectomy.Compared with lobectomy group patients Sublobar group were much elder(t=1.205,P=0.229);The proportion of sublobar resection group was higher in 70 years of age or older patients compare with the lobectomy group(t=20.6,P<0.05);sublobar resection more complications than lobectomy group(t=11.1,P=0.011).(2)Compare with the lobectomy group,the sublobar group had shorter operation time[(100.6±51.9VS141.2±46.5)min],less Post operative complications[14(17.9%VS47(34.3%)]and less total hospitalization expenses[(0.41±0.18VS0.46±0.18)Million];However,the number and group number of lymph node dissection in sublobar group were all lower than those in lobectomy group,[(10.1±5.03VS14.9±7.5),(4.1±1.6VS5.5±1.6),P<0.05];(3)The ratio of IA stage lung cancer in sublobar group was significantly higher than that in lobectomy group(x~2=8.69,P=0.003),and the average tumor size was smaller than lobectomy group(1.55±0.77VS2.14±1.09,P<0.05).There was no significant difference in pathological type and tumor differentiation between two groups.(4)The early and medium-term prognosis of sublobar is not inferior to lobectomy.There is no difference in the 1,2 and 3 years'disease-free survival rate between sublobar resection and lobectomy resection[(96.2%VS 99.3%?91.0%VS 97.6%?91.0%VS 93.5%),P?0.05].Conclusion:Thoracoscopic sublobar resection is safe and effective in the treatment of early invasive non-small cell lung cancer,and it can achieve similar early and medium-term prognosis.However,The long-term follow-up and randomized controlled clinical trials is still needed to evaluate the long-term prognosis.