| Background and purpose: The detection rate of early non-small cell lung cancer has increased in recent years,and surgical treatment is an effective method for early non-small cell lung cancer treatment.Common surgical methods include lobectomy,segmentectomy,wedge resection and sleeve resection.The difference between lobectomy and segmentectomy in the preservation of patients’ lung function after surgery is in dispute,and segmentectomy can be further divided into typical segmentectomy and atypical segmentectomy according to the site of resection,and they differ in the difficulty of the operation.This experiment explored the differences in lung function retention between lobectomy and segmental resection,and further compared the differences in postoperative lung function between patients with typical segmental resection and atypical segmental resection.METHODS: Patients who underwent lobectomy and segmentectomy from July 2017 to June 2018 in Qingdao University Hospital were enrolled,and patients in the segmentectomy group were further divided into typical and atypical segmentectomy groups.The propensity score matching method matched the patients in the lobectomy and segmentectomy group,typical and atypical segmentectomy group,and successfully matched 45 pairs(90 cases)in the lobectomy and segmentectomy group,22 pairs(44cases)in the typical and atypical segmentectomy group,then we compared the retention rate of lung function at 3 months and 6 months after surgery,and compared the difference of postoperative pulmonary function retention in postoperative short-term and long-term of each group.RESULTS:The typical segmental resection and atypical segmental resection were similar in the retention of FEV1 and FVC at 3 months and 6 months after operation,the difference was not statistically significant:The retention rates of forced vital capacity(FVC)and forced expiratory volume in one second(FEV1)were significantly different at3 months after lobectomy and segmentectomy.But when the postoperative time wasextended to 6 months,the difference lost statistical significance:at 3 months,the difference in FEV1 retention between lobectomy and segmentectomy was statistically significant(76.23±5.23%,82.67±7.26%,P=0.0016);the difference was significant in FVC retention between lobectomy and segmentectomy(74.76±6.15%,80.79±9.37%,P=0.029).At 6 months,there was no significant difference in FEV1 retention between lobectomy and segmentectomy(85.13±9.12%,86.92±5.53%,P=0.67);there was no significant difference in FVC retention between lobectomy and segmentectomy(83.36±3.12%,85.75±5.32%,P=0.31).The typical segmental resection and atypical segmental resection were similar in the retention of FEV1 and FVC at 3months and 6 months after operation,the difference was not statistically significant:At 3months,there was no significant difference in FEV1 retention between patients with atypical segmentectomy and typical segmentectomy(81.26±7.73%,83.12±5.16%,p=0.27);there was no significant difference in FVC retention between patients with atypical segmentectomy and typical segmentectomy(79.63±7.23 %,80.98±8.15 %,p=0.35).At 6 months,there was no significant difference in FEV1 retention between patients with atypical segmentectomy and typical segmentectomy(86.25±9.12%,87.13±7.63%,P=0.83);there was no significant difference in FVC retention between patients with atypical segmentectomy and typical segmentectomy(85.36±5.27%,86.22±3.57%,P=0.46).CONCLUSIONS: In the short-term postoperative period,segmentectomy is superior to lobectomy,typical segmentectomy is superior to atypical segmentectomy in postoperative pulmonary function retention.However,when the postoperative time was extended to 6 months,the lung function retention between the groups haven’t significant difference.The difference in lung function retention between patients with segmental resection and lobectomy was reduced with the extension of postoperative time.There is no significant difference in postoperative lung function between patients with typical segmentectomy and atypical segmentectomy. |
