| Objective:Combined with the clinical data of different basal segment resection ranges of stage T1 a lung adenocarcinoma,compared the short-term clinical efficacy and safety between total basal segment resection and partial basal segment resection,and to further discuss the selection of surgical methods in combination with relevant research indicators and literatures.Methods:In this study,cases were selected according to inclusion criteria and exclusion criteria.the entire basal segment resection was divided into the control group,and part of the basal segment resection,including anterior,posterior,lateral basal segment and combined segment resection,was divided into the study group.A retrospective study was conducted to collect 56 cases of patients with T1 a stage lung adenocarcinoma who underwent surgical treatment in the department of thoracic surgery of our hospital from January 2016 to January 2018,including 34 cases in the research group and 22 cases in the control group.In the study group,4 cases of posterior basal segment resection,16 cases of external basal segment resection,7 cases of anterior medial basal segment resection,and 7 cases of posterior lateral basal segment resection.Statistics from the clinic,hospital medical records and telephone follow-up results,collect the preoperative clinical data of postoperative patients,compared two groups of operation time,number,lymph node metastasis lymph node cleaning the stop number,three days after the breast volume and postoperative catheter time,postoperative hospitalization days,postoperative complications and recurrence rate after one year.Results:(1)Preoperative clinical data of all patients in the two groups included gender,age,smoking history,family history of cancer,history of coronary heart disease,history of hypertension,and nodule size and location,etc.,and no statistical difference was found(P > 0.05),indicating that the two groups were comparable.The incidence of early lung adenocarcinoma was higher in women,non-smokers,and younger.(2)Among the postoperative indicators of the two groups: the total volume of chest drainage[(602.05.33±175.82)ml],postoperative catheterization time[(3.77±0.75)d],postoperative hospitalization time [(4.59±0.50)d] in the study group showed statistical differences(P < 0.05)with the control group in the total volume of chest drainage[(602.05.33±175.82)ml],postoperative catheterization time[(4.24±0.82)d],postoperative hospitalization time [(5.41±0.99)d ].However,no difference was found in operation time,lymph node dissection and number of metastasis stations(P > 0.05)between the two group.(3)In the comparison of postoperative complications,there were no difference between the two groups in terms of pulmonary leakage,atelectasis,pneumonia,arrhythmia,myocardial infarction and pulmonary infarction(P > 0.05).Among all the13 cases with postoperative complications,8 cases(61.5%)had pulmonary leakage,which was the most common postoperative complication.However,there were no statistical difference between the two groups(P =0.911> 0.05).(4)Prognostic indicators: among the 56 cases,7 cases lost follow-up(2 cases in the control group and 5 cases in the study group),and the other 49 cases did not show tumor recurrence,metastasis or tumor-related death.There was no difference between the two groups in the increase of postoperative tumor markers(both higher than normal values)compared with that before surgery(P > 0.05).(5)There were 32 cases(71%)of non-invasive adenocarcinoma in all ground glass nodules,and 10 cases(91%)of invasive adenocarcinoma in all solid nodules,with statistical difference(P < 0.05).It can be seen that the majority of solid nodules were invasive adenocarcinoma,while the majority of ground glass nodules were non-invasive adenocarcinoma.There were 5 cases of lymph node metastasis in the two groups aftersurgery,and the pathological types were all invasive adenocarcinoma,among which 4cases were mainly acinar type and 1 case was mainly mural structure type.There was a statistical difference between lymph node metastasis and nodular solid components and pathological types(P < 0.05),indicating a correlation.Conclusion:There were statistical differences between the two groups in the total volume of thoracic drainage,postoperative catheterization time and postoperative hospitalization time three days after the operation,but no differences in the operation time,number of lymph node dissection stations,number of lymph node transfer stations,and postoperative tumor recurrence and metastasis.Overall,partial basal segment resection has advantages for T1 a lung adenocarcinoma,which is safe and effective in short-term efficacy. |
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