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  • Title: [Effects of VATS Lobectomy, VATS Anatomic Segmentectomy, and Open Thoracotomy on Pulmonary Function of Patients with Non-small Cell Lung Cancer].
    Author: Zhang Y, Gao Y.
    Journal: Zhongguo Fei Ai Za Zhi; 2016 Oct 20; 19(10):700-704. PubMed ID: 27760602.
    Abstract:
    BACKGROUND: Lung cancer is a malignancy with high morbidity and mortality rates worldwide. Surgery is the preferred treatment for non-small cell lung cancer. This study aims to investigate the effects of video-assisted thoracoscopic surgery (VATS) lobectomy, VATS segmentectomy, and open thoracotomy on pulmonary function in the early postoperative stage and compare the difference among three groups. METHODS: Pulmonary function data of patients were collected from September 2015 to February 2016 in Department of Thoracic Surgical Oncology, Cancer Hospital Chinese Academy of Medical Sciences. The patients were categorized according to operation methods into three groups, namely, VATS segmentectomy, VATS lobectomy, and open thoracotomy groups. Pulmonary function was assessed 1 day before the surgery, 3 days after the surgery, and 3 months after the surgery. Statistical analysis was performed with SPSS 20.0 through single-factor analysis of variance. RESULTS: Pulmonary function 3 days after the surgery was compared among the three groups. There was a significant difference in forced vital capacity (FVC), FVC%, forced expiratory volume in one second (FEV1), FEV1%, peak expiratory flow (PEF), maximal voluntary ventilation (MVV), transfer factor for carbon monoxide of lung (TLCO) and TLCO% (P values were as follows: 0.033, 0.042, 0.029, 0.045, 0.039, 0.021, 0.018, 0.024). The comparison of pulmonary function of 3 groups at the time of 3 months after operation showed that there was a significant difference among three groups in FVC, FVC%, FEV1, FEV1%, PEF, MVV, TLCO, TLCO% (P values were as follows: 0.019, 0.024, 0.044, 0.021, 0.037, 0.029, 0.045, 0.017). CONCLUSIONS: No matter in the early stage after surgery or at the time of 3 months after surgery, the patients' pulmonary function in VATS segmentectomy is better than the data of VATS lobectomy group, and the pulmonary function data of VATS lobectomy patients recovered better than the open thoracotomy group.
. 背景与目的 肺癌是世界范围内发病率和死亡率最高的恶性肿瘤之一，手术仍然是早期非小细胞肺癌的首选治疗方法。本研究的目的是探讨术后极早期肺功能的恢复情况，并比较肺癌胸腔镜肺叶切除、胸腔镜肺段切除与开胸肺叶切除术后对肺功能影响。方法 选取中国医学科学院肿瘤医院胸外科2015年9月-2016年2月间手术的肺癌患者，按术式不同分为胸腔镜肺段切除术组、胸腔镜肺叶切除术组、开胸肺叶切除术组，分别于术前、术后第3天和术后3个月检查测试肺功能。统计分析采用SPSS 20.0版本，应用单因素方差分析，比较组间差异。结果 ①在术后第3天，对比胸腔镜肺叶切除术、胸腔镜肺段切除术、开胸肺叶切除术，三组患者的肺功能，用力肺活量（forced vital capacity, FVC）、FVC占预计值的百分比（FVC%）、一秒用力呼气容积（forced expiratory volume in one second, FEV1）、FEV1占预计值的百分比（FEV1%）、最大呼气流速峰值（peak expiratory flow, PEF）、每分钟最大通气量（maximal voluntary ventilation, MVV）、肺一氧化碳弥散因子（transfer factor for carbon monoxide of lung, TLCO）、TLCO占预计值的百分比（TLCO%），组间差异具有统计学意义（P值分别为0.033、0.042、0.029、0.045、0.039、0.021、0.018、0.024）。②在术后3个月，对比胸腔镜肺叶切除术、胸腔镜肺段切除术、开胸肺叶切除术，三组患者的肺功能，组间比较发现FVC、FVC%、FEV1、FEV1%、PEF、MVV、TLCO、TLCO%差异显著（P值分别为0.019、0.024、0.044、0.021、0.037、0.029、0.045、0.017）。结论 肺癌胸腔镜肺叶切除、胸腔镜肺段切除与开胸肺叶切除术后在术后极早期（术后第3天）与术后3个月，肺功能的恢复情况均为胸腔镜肺段切除优于胸腔镜肺叶切除，胸腔镜肺叶切除优于开胸肺叶切除。.
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