胸腔镜解剖性肺段切除术和肺叶切除术对早期肺癌患者近期生活质量的对比分析

Comparison of short-term effect between video-assisted thoracoscopic anatomic segmentectomy and lobectomy for early-stage lung cancer

目的:比较胸腔镜肺叶切除术和解剖性肺段切除术对早期肺癌患者术后近期生活质量的差异。方法:选取我院2018年6月至2020年6月收治的使用胸腔镜肺叶切除术或解剖性肺段切除术早期肺癌患者132例,其中肺叶切除组64例,肺段切除组68例。比较2组患者围手术期情况,术前、术后1个月以及术后3个月的肺功能指标,术后3个月生活质量。结果:肺叶切除组手术时间在(104.32±13.21)min,肺段切除组手术时间在(115.00±11.18)min(P<0.05),但肺段切除组内包含了联合亚段切除,进一步组内分析后2组手术时间差异无统计学意义。肺段切除组患者更容易出现肺部漏气情况。肺段切除组患者术后1个月肺功能恢复较肺叶切除组更具优势(P<0.05),但3个月后2组肺功能基本恢复至术前水平。QLQ-C30、QLQ-LC13评分反映出肺段切除组患者在总体健康状况、社会功能、情绪功能等指标中要优于肺叶切除组(P<0.05)。结论:胸腔镜肺段切除术比肺叶切除术在早期肺癌患者近期生活质量对比中更具优势。

Objective:To compare the safety and short-term effect of video-assisted thoracoscopic(VATS)anatomic segmentectomy and VATS anatomic lobectomy for the early-stage lung cancer.Methods:A total of 132 patients with early-stage lung cancer who underwent VATS anatomic segmentectomy or lobectomy for early-stage lung cancer from Jun 2018 to Jun 2020 were selected,including lobectomy group(n=64)and segmentectomy group(n=68).The perioperative condition,changes of pulmonary function before and after operation,and quality of life at 3 months after operation were compared and analyzed between the two groups.Results:The operation time was(104.32±13.21)min in lobectomy group and(115.00±11.18)min in segmentectomy group(P<0.05).But combined subsegmental lobectomy was included in segmentectomy group.There was no significant difference in operation time between the two groups after further analysis.Patients with segmentectomy were more likely to have pulmonary air leakage.The recovery of pulmonary function in the segmentectomy group was more advantageous than that in the lobectomy group at 1 month after operation,but the pulmonary function in the two groups basically recovered to the preoperative level after 3 months.QLQ-C30 and QLQ-LC13 scores showed that the overall health status,social function and emotional function of the patients in the segmentectomy group were better than those in the lobectomy group(P<0.05).Conclusion:VATS segmentectomy has more advantages than lobectomy in the comparison of short-term quality of life in patients with early-stage lung cancer.