The Clinical Analysis Of Perioperative Efficacy In Treatment Of Stage IA Non-small Cell Lung Cancer By Thoracoscopic Anatomic Segmentectomy

Objective:By comparing and analyzing the efficacy of thoracoscopic anatomic segmentectomy and thoracoscopic lobectomy in the perioperative period of the treatment of stage IA(T1a-bN0M0)non-small Cell Lung Cancer(NSCLC),it is expected to provide some references for clinicians in the choice of surgical methods for patients with early stage non-small Cell Lung Cancer.Methods:A total of 110 patients with early NSCLC who met the inclusion criteria and were admitted to the department of thoracic surgery of the first affiliated hospital of nanchang university from January 2018 to January 2020 were retrospectively analyzed.After admission,all patients completed the relevant routine preoperative examination to exclude distant metastasis and contraindications related to surgery.Through high resolution computer tomography(HRCT)to choose the largest diameter 2 cm or less lung lesions,they were performed the Video-assisted Thoracoscopic Surgery(VATS)according with surgical indication.According to different surgical methods,the patients were divided into the thoracoscopic anatomic segmentectomy group(52 cases)and the thoracoscopic lobectomy group(58 cases).The intraoperative blood loss,number of intraoperative lymph nodes dissection,operation time,total postoperative thoracic drainage volume,postoperative thoracic closed drainage tube indwelling time,postoperative hospitalization days,postoperative pain degree on day 1 and day 3,and postoperative complications were observed and recorded.Results:In both groups,the operation was completed successfully under thoracoscope,and there were no transferred thoracotomy or perioperative death cases.Through statistical analysis,it was found that the intraoperative blood loss,postoperative thoracic drainage volume,postoperative closed thoracic drainage tube retention timeand postoperative hospitalization days of the patients in the thoracoscopic anatomic segmentectomy group were all lower than those in the thoracoscopic lobectomy group,the difference is statistically significant(P<0.05);The former was longer than the latter,and the difference was statistically significant(P<0.05),there was no statistically significant difference between the two groups in the number of lymph nodes dissection,the degree of pain on the first and third days after surgery,and the occurrence of postoperative complications(P>0.05).Conclusions:Both thoracoscopic anatomic segmentectomy and lobectomy can safely and effectively treat stage IA non-small cell lung cancer with the maximum diameter ?2cm,However,the advantage of the former that resumes more pulmonary function for patients conforms to the concept of Minimally Invasive Surgery(MIS)and Enhanced Recovery After Surgery(ERAS),It is positive significance to the postoperative health of patients.Therefore,on the premise of strictly grasping the indications of segmentectomy,it can replace lobectomy to some extent for the treatment of selected patients with early non-small cell lung cancer,which is worthy of clinical promotion and application.