摘要
目的比较单孔胸腔镜下开展肺段切除术与肺亚段切除术在老年肺结节患者围术期指标以及短期预后的效果差异。方法选择河南省人民医院2022年1月至2024年12月收治的60例老年肺结节患者,根据术式不同,分为肺段组(接受肺段切除术,32例),和肺亚段组(接受肺亚段切除术,28例)。比较两组患者基线资料与疾病特征、手术相关及围术期指标、手术前和术后6个月的肺功能指标、术后并发症以及短期预后结局差异。结果两组患者肿瘤-淋巴结-远处转移(TNM)分期、病理类型、清扫淋巴结个数、术后首次下床活动时间比较,差异无统计学意义(P>0.05),肺亚段组术中出血量和术后引流量均少于肺段组,且总住院时间短于肺段组,但手术时间长于肺段组,差异有统计学意义(P<0.05)。术后6个月,两组第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、最大通气量(MVV)水平均较术前升高,且肺亚段组高于肺段组,差异存在统计学意义(P<0.05)。肺亚段组术后并发症发生率低于肺段组,差异有统计学意义(P<0.05)。术后随访6个月内,两组患者均不存在肺结节复发、转移或患者死亡等不良预后结局。结论肺亚段切除术和肺段切除术的短期预后无明显差异。虽然肺亚段切除术耗时更长,但该术式手术期间出血量和术后引流量更少,有助于老年肺结节患者术后肺功能康复,降低患者术后并发症发生率。
Objective To compare the differences in perioperative parameters and short-term prognosis between uniportal video-assisted thoracoscopic pulmonary segmentectomy and subsegmentectomy in elderly patients with pulmonary nodules.Methods A total of 60 elderly patients with pulmonary nodules who were admitted to Henan Provincial People’s Hospital from January 2022 to December 2024 were enrolled.According to the surgical procedure,the patients were divided into a segmentectomy group(undergoing pulmonary segmentectomy,n=32)and a subsegmentectomy group(undergoing subsegmentectomy,n=28).Baseline data and disease characteristics,operative and perioperative parameters,pulmonary function indices before surgery and at 6 months after surgery,postoperative complications,and short-term prognostic outcomes were compared between the two groups.Results There were no statistically significant differences between the two groups in tumornode-metastasis(TNM)stage,pathological type,number of lymph nodes dissected,or time to first ambulation after surgery(P>0.05).Intraoperative blood loss and postoperative drainage volume in the subsegmentectomy group were lower than those in the segmentectomy group,and total length of hospital stay was shorter in the subsegmentectomy group,whereas operative time was longer than that in the segmentectomy group;these differences were statistically significant(P<0.05).At 6 months after surgery,forced expiratory volume in one second(FEV_(1)),forced vital capacity(FVC),and maximal voluntary ventilation(MVV)in both groups were higher than the corresponding preoperative levels,and all three indices were higher in the subsegmentectomy group than in the segmentectomy group,with statistically significant differences(P<0.05).The incidence of postoperative complications in the subsegmentectomy group was lower than that in the segmentectomy group(P<0.05).During the 6-month postoperative follow-up period,no patients in either group experienced recurrence or metastasis of pulmonary nodules,and no deaths occurred.Conclusion The short-term prognostic outcomes of subsegmentectomy and pulmonary segmentectomy are comparable in elderly patients with pulmonary nodules.Although subsegmentectomy requires a longer operative time,this procedure is associated with less intraoperative blood loss and reduced postoperative drainage volume,and it is beneficial for postoperative recovery of pulmonary function and for reducing the incidence of postoperative complications in elderly patients with pulmonary nodules.
作者
刘孟博
马泽恒
魏文学
杨军峰
魏立
LIU Mengbo;MA Zeheng;WEI Wenxue;YANG Junfeng;WEI Li(Department of Thoracic Surgery,Henan Provincial People’s Hospital,Zhengzhou,Henan 450000,China)
出处
《临床研究》
2025年第12期10-13,共4页
Clinical Research
关键词
肺结节
肺亚段切除术
肺段切除术
围术期
短期预后
pulmonary nodule
subsegmentectomy
pulmonary segmentectomy
perioperative period
short-term prognosis
