Explore the feasibility of subsegmentectomy in clinical application
10.3760/cma.j.cn112434-20241119-00286
- VernacularTitle:肺亚段切除治疗2 cm以内非小细胞肺癌近中期临床疗效评价
- Author:
Fei QI
1
;
Hongxiang FENG
;
Yu HAN
;
Fei XIAO
;
Yuhui SHI
;
Chaoyang LIANG
;
Deruo LIU
;
Fanjia KONG
;
Zhenrong ZHANG
Author Information
1. 中日友好医院（中日友好临床医学研究所） 北京协和医学院 中国医学科学院，北京 100029
- Publication Type:Journal Article
- Keywords:
Non-small cell lung cancer;
Thoracoscopic surgery;
Subsegmentectomy
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2025;41(1):10-15
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Analyze the imaging and clinical data of cases undergoing thoracoscopic subsegmental resection for non-small cell lung cancer(NSCLC) with a diameter≤2 cm, and explore the clinical outcomes of subsegmental resection.Methods:A retrospective analysis was conducted on the clinical data of 58 patients who underwent thoracoscopic subsegmentectomy in China-Japan Friendship Hospital from January 2020 to July 2024. Three-dimensional reconstruction technology was used for surgical planning before the operation, and thoracoscopic subsegmentectomy was performed, including single lung subsegmentectomy(Group 1), multiple lung subsegmentectomy(Group 2), and combined segmentectomy and subsegmentectomy(Group 3).Results:All patients successfully completed the surgery, with 23 cases of single lung subsegmentectomy, 6 cases of multiple lung subsegmentectomy, and 29 cases of combined segmentectomy and subsegmentectomy. The median intraoperative blood loss was 30.0(20.0, 30.0)ml, the average operation time was(2.03±0.68) h, the average pathological size of the nodules was(10.53±4.45) mm, and the average postoperative tube retention was(2.55±0.92) days. There were 6 cases of postoperative complications, including pulmonary air leakage in 2 cases, cerebral embolism in 1 case, pulmonary embolism in 1 case, pulmonary infection in 1 case, and atrial fibrillation in 1 case. All patients had negative surgical margins in the postoperative pathology. Group 1 had less average intraoperative blood loss than Group 2, with statistically significant differences( P=0.027). Surgical procedures for the upper lobe of the lung mainly involve the resection of combined segments and subsegments, while those for the lower lobe primarily consist of single segmentectomy. Conclusion:Subsegmentectomy is an effective surgical approach when the nodule is small and a clear margin can be ensured, allowing for better preservation of remaining lung tissue. Bleeding during multiple subsegmentectomies is greater than that in single subsegmentectomy and combined segmentectomy with subsegmentectomy, which may be related to the more complex vascular variations in multiple subsegmentectomies.
