Journal of Shandong University (Health Sciences) ›› 2022, Vol. 60 ›› Issue (11): 38-43.doi: 10.6040/j.issn.1671-7554.0.2022.0606

• Special Issue in Minimally Invasive Surgery and Enhanced Recovery After Surgery in Lung Cancer and Esophageal Cancer • Previous Articles     Next Articles

Comparison of 34 cases of thoracoscopic wedge resection and 21 cases of segmental resection for stage ⅠA1 non-small cell lung cancer in area P

Huining LIU*(),Jun PENG,Yingchun REN,Guang YANG,Wenhao WANG,Jinfeng LIU,Qing TIAN   

  1. Department of Thoracic Surgery, the First Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei, China
  • Received:2022-05-18 Online:2022-11-01 Published:2022-11-04
  • Contact: Huining LIU E-mail:liuhuining1972@163.com

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Abstract:

Objective: To investigate the selection of minimally invasive thoracoscopic surgery for stage ⅠA1 non-small cell lung cancer (NSCLC) in area P by dividing the lung segment location of the lesion according to the imaging data, and to compare the prognosis of the two methods. Methods: A retrospective analysis was performed on 55 patients who underwent thoracoscopic wedge resection and segmentectomy, and the patients were divided into wedge resection group (group A, n=34) and segmentectomy group (group B, n=21). Results: In groups A and B, the operation time, postoperative hospital stay, intraoperative bleeding, hospitalization costs, and incidence of postoperative pulmonary air leakage were (18.50±5.55) vs. (61.23±9.83), (3.14±0.95) d vs. (4.95±1.39) d, (12.67±6.54) mL vs. (103.71±16.99) mL, (35, 900±5, 000) yuan vs. (61, 900±10, 200) yuan, 5.88% (2 cases) vs. 28.57% (6 cases), respectively, with statistically significant differences (all P < 0.05). Univariate Logistic regression analysis showed a significant correlation between operation time, postoperative hospital stay, incidence of lung leakage and different operation methods (P < 0.05). Multivariate binary Logistic regression analysis showed that compared with group B, group A had shortened operation time (OR=2.58, 95%CI: 1.71-3.90, P < 0.001), shorter postoperative hospital stay (OR=2.91, 95%CI: 1.01-8.84, P=0.04) and reduced incidence of lung leakage (OR=7.12, 95%CI: 1.13-37.21, P=0.04). Conclusion: For patients with stage ⅠA1 NSCLC, thoracoscopic wedge resection of lung with lesion located in area P has a significant advantage over segmental resection.

Key words: Non-small cell lung cancer, New lung segmental partition, P area, Wedge resection, Segmental resection

CLC Number: 

  • R734.2

Table 1

Clinical characteristics of patients with stage ⅠA1 non-small cell lung cancer in area P in group A and group B"

特征 A组(n=34) B组(n=21) t/χ2 P
性别[ n(%)] 0.01 0.92
  男 19(55.88) 12(57.14)
  女 15(44.12) 9(42.86)
年龄(岁) 56.41±11.55 57.05±11.78 0.21 0.83
病例类型[ n(%)] 0.06 0.96
  原位癌 12(35.29) 8(38.09)
  微浸润癌 20(58.82) 12(57.14)
  其他 2(5.89) 1(4.77)
P区肿瘤位置[ n(%)] 0.75 0.94
  右肺上叶 6(17.65) 4(19.05)
  右肺中叶 5(14.71) 2(9.52)
  右肺下叶 8(23.52) 5(23.81)
  左肺上叶 7(20.60) 6(28.57)
  左肺下叶 8(23.52) 4(19.05)

Table 2

Comparison of surgical results between patients with stage Ⅰ A1 non-small cell lung cancer in area P in group A and group B"

特征 A组(n=34) B组(n=21) t P
手术时间(min) 18.50±5.55 61.23±9.83 20.63 ＜0.001
术后住院时间(d) 3.14±0.95 4.95±1.99 5.69 ＜0.001
术中出血量(mL) 12.67±6.54 103.71±16.99 28.06 ＜0.001
住院费用(万元) 3.59±0.50 6.19±1.02 12.63 ＜0.001

Table 3

Comparison of incisional margin recurrence and postoperative complications between patients with stage ⅠA1 non-small cell lung cancer in area P in group A and group B[n(%)]"

特征 A组(n=34) B组(n=21) P
肺不张 3(8.82) 5(23.81) 0.23
肺漏气 2(5.88) 6(28.57) 0.04
发热 4(11.76) 5(23.81) 0.28
心律失常 2(5.88) 4(19.05) 0.18
切缘复发 0(0.00) 0(0.00) —

Table 4

Logistic regression analysis of related factors of the two surgical methods"

影响因素 单因素分析 多因素分析
OR(95%CI) P OR(95%CI) P
性别 1.05(0.35~3.15) 0.93 — —
年龄 0.95(0.32~2.85) 0.84 — —
P区肿瘤位置 0.87(0.29~2.59) 0.80 — —
手术时间 2.55(1.67~3.91) < 0.001 2.58(1.71~3.90) < 0.001
术后住院时间 4.35(1.99~9.47) < 0.001 2.91(1.01~8.84) 0.04
术中出血量 1.18(0.39~3.54) 0.76 — —
住院费用 3.72(0.54~6.09) 0.07 — —
肺不张 0.31(0.06~1.46) 0.14 0.28(0.06~1.46) 0.13
肺漏气 6.40(1.15~35.52) 0.03 7.12(1.13~37.21) 0.04
发热 0.43(0.10~1.82) 0.25 0.40(0.08~1.86) 0.24
心律失常 0.27(0.04~1.60) 0.15 0.25(0.04~1.60) 0.14
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