Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 6, 2020; 8(11): 2227-2234
Published online Jun 6, 2020. doi: 10.12998/wjcc.v8.i11.2227
Efficacy of thoracoscopic anatomical segmentectomy for small pulmonary nodules
Hui Li, Yang Liu, Bao-Cun Ling, Bo Hu
Hui Li, Yang Liu, Bao-Cun Ling, Bo Hu, Cardiothoracic Surgery Department, Zibo Hospital, 960 Hospital of PLA, Zibo 255300, Shandong Province, China
Author contributions: Li H and Liu Y contributed equally to this article and should be considered as co-first authors; Ling BC and Hu B performed the operation; Li H and Liu Y designed this retrospective study; Ling BC and Hu B wrote this paper; Li H and Liu Y was responsible for sorting the data.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of 960 Hospital of PLA.
Informed consent statement: Informed consent was obtained from the patients.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Bao-Cun Ling, BHMS, Chief Physician, Cardiothoracic Surgery Department, Zibo Hospital, 960 Hospital of PLA, No. 20, Zhanbei Road, Zhoucun District, Zibo 255300, Shandong Province, China. 2189358576@qq.com
Received: March 22, 2020
Peer-review started: March 22, 2020
First decision: April 19, 2020
Revised: April 24, 2020
Accepted: May 21, 2020
Article in press: May 21, 2020
Published online: June 6, 2020
Abstract
BACKGROUND

Small pulmonary nodules are tissue shadows and thoracoscopic segmentectomy in China is still at the exploratory stage with limited application.

AIM

To evaluate the efficacy of thoracoscopic anatomical segmentectomy for small pulmonary nodules.

METHODS

Medical records of 86 patients with small pulmonary nodules treated at our hospital between August 2016 and October 2019 were retrospectively analyzed; 40 cases who underwent thoracoscopic lobectomy were set as a reference group, and 46 cases who underwent thoracoscopic anatomical segmentectomy were set as an observation group. Preoperative and postoperative parameters were measured in both groups, including the percentage of forced expiratory volume in the first second (FEV1%), the percentage of forced vital capacity (FVC%), and the FEV1/FVC ratio (FEV1/FVC). Patients with positive pathological diagnosis received tests for neuron-specific enolase, carbohydrate antigen 125 (CA125), CA19-9, and squamous cell carcinoma antigen. Intraoperative bleeding volume, drainage volume, the number of dissected lymph nodes, drainage time, hospital stay, treatment cost, postoperative complications, and postoperative pain condition were compared between the two groups.

RESULTS

No significant difference was observed in the results of four serum tumor marker (CA125, CA19-9, squamous cell carcinoma antigen, and neuron-specific enolase), the number of dissected lymph nodes, treatment cost, or preoperative pulmonary ventilation index between the two groups. Intraoperative bleeding volume, drainage volume, drainage time, hospital stay, and visual analogue scale score were significantly lower in the observation group (P < 0.05). The results of FEV1%, FVC%, and FEV1/FVC were significantly higher in the observation group (P < 0.05).

CONCLUSION

The efficacy of thoracoscopic anatomical segmentectomy and lobectomy for small pulmonary nodules shows no significant difference in terms of lesion removal, but anatomical segmentectomy is less invasive with fewer postoperative complications and less influence on lung function.

Keywords: Thoracoscopy, Small pulmonary nodules, Anatomical segmentectomy, Clinical efficacy, Lobectomy

Core tip: To evaluate the efficacy of thoracoscopic anatomical segmentectomy for small pulmonary nodules, this study retrospectively analyzed the medical records of 86 patients with small pulmonary nodules treated at our hospital.