Pulmonary function protection by single-port thoracoscopic segmental lung resection in elderly patients with IA non-small cell lung cancer: A differential matched analysis

• Published in: Medicine (Baltimore) 2023-04, Vol.102 (17), p.e33648-e33648
• Main Authors: Wang, Silin, Shi, Yonggang, Chen, Heng, Xiong, Jianwen, Zhang, Xinle, Zhang, Yelin, Zhu, Kang, Yu, Dongliang, Wei, Yiping, Xiong, Linmin
• Format: Article
• Language: English
• ISSN: 0025-7974
• DOI: 10.1097/MD.0000000000033648

In patients with stage IA non-small cell lung cancer (NSCLC), uniportal video-assisted thoracic surgery (U-VATS) anatomical segmentectomy removes the lung tumor while preserving lung function as much as possible, and it is therefore an alternative to lobectomy. Patients with stage IA NSCLC receiving U-VATS segmental resection at our institution from September 2017 to June 2019 were compared with patients receiving U-VATS lobectomy. A total of 47 patients received segmentectomy and 209 patients received U-VATS lobectomy in the same period. Propensity score matching was conducted to diminish bias. The final study cohort included 42 patients who received segmentectomy and 42 propensity score matching-matched patients who received lobectomy. Perioperative parameters and postoperative complications, length of hospital stay, postoperative forced expiratory volume in 1 s (FEV1), and forced vital capacity (FVC) were compared between the 2 groups. Surgery was successfully completed in all patients. The mean follow-up was for 8.2 months. The postoperative complication rate was comparable between the 2 groups31.0% in segmentectomy patients versus 35.7% in lobectomy patients ( P = .643). At 1 month after surgery, FEV1% and FVC% were not significantly different between the 2 groups ( P > .05). At 3 months after surgery, FEV1 and FVC were higher in segmentectomy patients than in lobectomy patients (FEV1, 82.79% ± 6.36% vs 78.55% ± 5.42%; FVC, 81.66% ± 6.09% vs 78.90% ± 5.58%, P < .05). Patients receiving segmentectomy suffer less pain and have better postoperative lung function and higher quality of life.