Short-term efficacy and safety of sublobectomy based on intersegmental vein-centered planning for treatment of intersegmental early-stage non-small cell lung cancer
10.3760/cma.j.cn115355-20241209-00563
- VernacularTitle:基于段间静脉中心规划的亚肺叶切除术治疗段间早期非小细胞肺癌的近期效果及安全性
- Author:
Yan ZHAO
1
;
Bin YOU
;
Hui LI
Author Information
1. 首都医科大学附属北京朝阳医院 北京市呼吸疾病研究所胸外科，北京 100020
- Publication Type:Journal Article
- Keywords:
Carcinoma, non-small-cell lung;
Pulmonary nodules;
Three-dimensional imaging;
Preoperative planning;
Sublobectomy
- From:
Cancer Research and Clinic
2025;37(4):262-267
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the short-term efficacy and safety of intersegmental vein-centered planning sublobectomy (VCPS) in the treatment of intersegmental early-stage non-small cell lung cancer (NSCLC).Methods:A prospective cohort study was conducted. A total of 68 patients with early-stage NSCLC who underwent VCPS in Beijing Chao-Yang Hospital, Capital Medical University from May to November 2023 were successively included. A group of 71 patients who underwent combined segmentectomy or subsegmentectomy (CSS) during the same period was selected as the control. Preoperative three-dimensional (3D) imaging technology was used for surgical planning in the VCPS group, with tumor resection centered around intersegmental veins during the operation. In the CSS group, combined segment or subsegment resection was performed based on preoperative 3D planning. The operative time, complications, resection margin distance, hospitalization costs, and short-term follow-up results of both groups were compared.Results:The VCPS group included 29 males (42.6%) and 39 females (57.4%), with the age of (61±11) years and the tumor diameter of (10.4±3.1) mm; the postoperative pathology types revealed adenocarcinoma in situ (AIS) in 31 cases (45.6%), minimally invasive adenocarcinoma (MIA) in 23 cases (33.8%), and invasive adenocarcinoma (IA) in 14 cases (20.6%). The CSS group included 27 males (38.0%) and 44 females (62.0%), with the age of (59± 11) years and the tumor diameter of (9.9±2.9) mm; the postoperative pathology types revealed AIS in 31 cases (43.7%), MIA in 27 cases (38.0%), and IA in 13 cases (18.3%). There were no statistically significant differences in gender, age, tumor diameter and pathological type distribution between the VCPS group and CSS group (all P > 0.05). The operative time [ M ( Q1, Q3)] in the VCPS group was shorter than that in the CSS group [90 (75, 100) min vs. 150 (120, 180) min, Z = -9.83, P < 0.01]; the hospitalization cost in the VCPS group was lower than that in the CSS group [(44 969±6 929) yuan vs. (61 476±10 661) yuan, t = -10.77, P < 0.01]. There was no statistically significant difference in resection margin distance between the two groups [(18±5) mm vs. (18±5) mm, t = 0.65, P > 0.05]. Postoperative complications in the VCPS group included 2 cases of prolonged air leak and 1 case of postoperative cholecystitis, while patients in the CSS group showed 4 cases of prolonged air leak and 1 case of conversion to thoracotomy due to intraoperative bleeding. There were no statistically significant differences in the incidence of postoperative prolonged air leak and drainage time of both groups (all P > 0.05). No tumor recurrence or metastasis was observed in either group during 3-month follow-up after operation. Conclusions:VCPS, which centers surgical planning around intersegmental veins, provides more precise anatomical localization for intersegmental NSCLC lesions, shortens operative time, reduces surgical difficulty and costs, and decreases postoperative complications.
