Application of thoracoscopic anatomic sublobar resection in the treatment of pulmonary nodules
10.7507/1007-4848.202104094
- VernacularTitle:胸腔镜解剖性亚肺叶切除在肺结节治疗中的应用
- Author:
Qirui CHEN
1
;
Bin HU
1
;
Yang WANG
1
;
Tong LI
1
;
Jinbai MIAO
1
;
Bin YOU
1
;
Yili FU
1
;
Hui LI
1
Author Information
1. Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, P.R.China
- Publication Type:Journal Article
- Keywords:
Lung cancer;
sublobar resection;
segmentectomy;
wedge resection
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2022;29(01):30-35
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the surgical procedure selection, operation technique and safety of anatomic sublobar resection for pulmonary nodules. Methods The clinical data of 242 patients with clinical stage ⅠA lung cancer who underwent anatomic sublobar resection in our hospital between 2017 and 2020 were retrospectively analyzed. There were 81 males and 161 females with a median age of 57.0 (50.0, 65.0) years. They were divided into 4 groups according to the surgical methods, including a segmentectomy group (n=148), a combined segmentectomy group (n=31), an enlarged segmentectomy group (n=43) and an anatomic wedge resection group (n=20). The preoperative CT data, operation related indexes and early postoperative outcomes of each group were summarized. Results The median medical history of the patients was 4.0 months. The median maximum diameter of nodule on CT image was 1.1 cm, and the consolidation/tumor ratio (CTR) was ≤0.25 in 81.0% of the patients. A total of 240 patients were primary lung adenocarcinoma. The median operation time was 130.0 min, the median blood loss was 50.0 mL, the median chest drainage time was 3.0 d, and the hospitalization cost was (53.0±12.0) thousand yuan. The operation time of combined segmentectomy was longer than that of the segmentectomy group (P=0.001). The operation time (P=0.000), intraoperative blood loss (P=0.000), lymph nodes dissected (P=0.007) and cost of hospitalization (P=0.000) in the anatomic wedge resection group were shorter or less than those in the other three groups. There was no significant difference in the drainage time, total drainage volume, air leakage or postoperative hospital stay among the four groups (P>0.05). Conclusion The combined application of segmentectomy and wedge resection technique provides a more flexible surgical option for the surgical treatment of early lung cancer with ground glass opacity as the main component.
