|
|
|
| Clinical Efficacy of Thoracoscopic Segmentectomy in Elderly Patients with Stage Ⅰ Lung Cancer |
| WANG Daomeng, PAN Zhong, HE Xiaoyong |
| Department of Thoracic Surgery, Jiangdu People's Hospital of Yangzhou, Yangzhou Jiangsu 225200 |
|
|
|
|
Abstract 【Objective】 To investigate the efficacy of thoracoscopic segmentectomy in elderly patients with stage Ⅰ non-small cell lung cancer (NSCLC).【Methods】 A total of 123 patients with stage Ⅰ NSCLC who underwent surgical treatment were enrolled and divided into a lobectomy group (n=47, thoracoscopic lobectomy) and a segmentectomy group (n=76, thoracoscopic segmentectomy). Intraoperative and postoperative outcomes, as well as pulmonary function at 3 and 6 months after surgery, were compared between the two groups. 【Results】 The segmentectomy group had significantly less intraoperative blood loss, shorter postoperative chest tube drainage duration, and shorter hospital stay than the lobectomy group, while the operative time of the observation group was longer than that of the control group (all P<0.05). There was no significant difference in postoperative complication rates between the two groups (P>0.05). No cases of recurrence, metastasis, or death were observed during follow-up at 3 and 6 months after surgery in both groups. At both 3 and 6 months postoperatively, pulmonary function parameters in the segmentectomy group were significantly better than those in the lobectomy group (P<0.05). 【Conclusion】 Thoracoscopic segmentectomy and lobectomy provide comparable safety and oncologic outcomes in elderly patients with stage Ⅰ NSCLC. However, segmentectomy offers greater minimally invasive advantages, including reduced intraoperative blood loss, faster postoperative recovery, and better short-term preservation of pulmonary function. Therefore, it is worthy of wider clinical application.
|
|
Received: 26 August 2025
|
|
|
|
|
|
[1] OKADA M,MIMAE T,TSUTANI Y,et al.Segmentectomy versus lobectomy for clinical stage ⅠA lung adenocarcinoma[J].Ann Card Surg,2014,3(2):153-159. [2] 袁永刚,马歌,叶波.JCOG0802/WJOG4607L研究:肺段切除能否成为早期肺癌的标准术式?[J].中国胸心血管外科临床杂志,2022,29(10):1254-1259. [3] 王忠照,唐昊.《中华医学会肺癌临床诊疗指南(2024版)》更新要点解读[J].海军军医大学学报,2025,46(1):17-23. [4] 陈亮,王俊,吴卫兵,等.胸腔镜精准肺段切除术技术流程和质量控制[J].中国胸心血管外科临床杂志,2019,26(1):21-28. [5] DUFFY S W,FIELD J K. Mortality reduction with low dose CT screening for lung cancer[J].N Engl J Med,2020,382(6):572-573. [6] 王腾飞,耿玉六,徐明,等. 胸腔镜下肺段切除与肺叶切除对早期肺癌患者疗效及生活质量的影响[J].中华保健医学杂志,2024,26(5):618-621. [7] 王清北,朱林,吴正国. NSCLC肺内叶段淋巴结转移规律及全胸腔镜肺叶切除术中淋巴结清扫方式的选择[J].国际肿瘤学杂志,2024,51(9):569-577. [8] 付毅,廉政君,拜都如拉?艾尼吐,等. 单孔胸腔镜下肺段及肺叶切除术治疗早期肺癌的临床效果[J].保健医学研究与实践,2024,21(1):60-64. [9] 万伟,张彬,刘勇志,等. 胸腔镜下肺叶切除、解剖性肺段切除、肺楔形切除治疗非小细胞肺癌的疗效分析[J].临床外科杂志,2024,32(3):266-270. [10] 邵长卿,崔育慧,李新,等. 肺叶切除术与肺段切除术对直径≤2 cm早期非小细胞肺癌患者肺通气功能指标及中远期预后的影响[J].现代生物医学进展,2022,22(14):2791-2795. [11] 余俊杰,陈宝钧,程晶,等. 胸腔镜下肺段或肺叶切除术对老年非小细胞肺癌患者肺功能及血气指标的影响[J].中国老年学杂志,2024,44(14):3362-3366. [12] 吴衷平,卢积榕,李永旺,等. 160例双孔全胸腔镜肺叶切除术在早期肺癌治疗中的应用[J].中华实验外科杂志,2023,40(8):1615-1618. [13] 周浩,胡青,杨洋,等. 胸腔镜下肺叶切除和肺段切除术对肺部恶性疾病患者术后并发症、肺功能及疼痛程度的影响[J].临床肺科杂志,2024,29(12):1887-1891. |
|
|
|