| Objectives So far,the treatment of lung cancer is still a comprehensive treatment method based on surgery.The preferred treatment method for early NSCLC is surgery.The NCCN has classified VATS segmental lung resection and wedge resection with VATS lobectomy as early NSCLC treatment teams.However,it is still controversial whether the best surgical treatment for early NSCLC is lobectomy or sublobar resection(including segmentectomy and wedge resection).Through discussing the influence of different VATS procedures on the perioperative period of early NSCLC patients,individualized and standardized treatment schemes are formulated.Methods Through research and comparison,the clinical data of early NSCLC patients who underwent thoracic surgery under thoracic surgery in Tangshan Workers Hospital from January 2019 to August 2019 were analyzed,and the surgery was performed according to NCCN guidelines,and the VATS lobectomy that met the inclusion criteria was selected.35 cases of early NSCLC patients underwent lobectomy group,31 cases of early NSCLC patients who came to our hospital for VATS segmentectomy in the same period as the segmentectomy group,and 36 cases of VATS wedge resection who went to our hospital during the same period were selected Early NSCLC patients were used as the wedge-shaped lung resection group,and the three groups of patients were compared for intraoperative blood loss(ml),postoperative chest drainage drainage volume(ml),postoperative extubation time(d),and one week before surgery,one week postoperative and one month postoperative lung ventilation function indicators: FEV1,FEV1%,FVC,FVC%.Results All three groups of patients completed the operation as scheduled,the operation went smoothly,no accidents occurred during the operation,the postoperative recovery was good,and there were no deaths.In terms of intraoperative blood loss(78.53±21.27 VS 121.13±22.68 VS 141.86±25.32,P=0.000),postoperative drainage volume(573.76±266.38 VS 586.13±173.76 VS 733.29±273.24,P=0.013)and thoracic tube retention time(4.32±0.81 VS 4.65±0.76 VS 5.46±1.22,P=0.000),lung wedge resection group and lung segment resection group are superior to lung lobectomy group,P<0.05,and so the difference is statistically significant.Lung function indexes of the three groups of patients one week after operation: FEV1(2.00±0.47 VS 1.86±0.26 VS 1.58±0.34,P=0.000),FEV1%(77.12±14.51 VS 71.66±11.07 VS 66.61±15.85,P=0.010),FVC(2.30±0.52 VS 2.23±0.30 VS 1.96±0.39,P=0.002),FVC%(83.70±15.54 VS 80.52±12.73 VS 74.80±13.51,P=0.032)and pulmonary function index one month after operation: FEV1(2.30±0.43 VS 2.20±0.30 VS 11.94±0.23,P=0.000),FEV1%(91.03±1.69 VS 88.33±10.15 VS 80.91±11.13,P= 0.001),FVC(2.70±0.50 VS 2.51±0.32 VS 2.20±0.36,P=0.000),FVC%(96.07±12.31 VS 93.93±8.65 VS 87.23±7.22,P=0.001)lung wedge resection group and lung segment resection group are both higher than lung lobectomy group,P<0.05,and so the difference is significant and statistically significant.Conclusions VATS lobectomy,VATS segmental resection and VATS wedge resection can achieve satisfactory surgical results.VATS lobectomy(including VATS segmental resection and VATS pulmonary wedge resection)compared with VATS lobectomy has the advantages of less intraoperative hemorrhage,less postoperative drainage volume and shorter placement time of postoperative thoracic closed drainage tube,and largely preserves healthy lung tissue,with less influence on lung function.Postoperative lung function is significantly better than VATS lobectomy,which can provide a surgical treatment method more in line with minimally invasive concept for early NSCLC patients.Figure0;Table6;Reference 150... |
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