Analysis of the safety and short⁃term efficacy of pulmonary subsegmentectomy versus segmentectomy in the treatment of early⁃stage small nodular lung cancer
Objective:This study aimed to analyze the safety and short-term efficacy of pulmonary subsegmentectomy in the treatment of early-stage of small nodule lung cancer,comparing to pulmonary segmentectomy. Methods:We retrospectively analyzed 367 patients with small lung nodules who underwent pulmonary subsegmentectomy or segmentectomy in the First Affiliated Hospital of Nanjing Medical University from April 2020 to December 2020. All these subjects were divided into two groups according to surgical types:pulmonary subsegmentectomy(107 cases) and pulmonary segmentectomy(260 cases). Perioperative clinical characteristics and short-term prognosis between these two groups were compared. Results:The mean surgical margin of the subsegmentectomy group was (2.58 ± 0.94)cm,the removal catheter time was(2.56 ± 0.85)days,and the hospital stay was(3.50 ± 1.07)days. Compared to pulmonary segmentectomy,subsegmentectomy had a similar surgical margin(P=0.446),removal catheter time(P=0.639),hospital stay(P=0.267)and pathological diagnosis(P=0.337),as well as postoperative complications,such as air leak,hoarseness,fever,arrhythmia and so on. The operative time of subsegmentectomy was(147.21 ± 37.97)min,which was longer than that of segmentectomy(134.66 ± 40.70)min(P=0.007). Besides,the hemorrhage of subsegmentectomy was (50.42 ± 38.59)mL,more than that in pulmonary segmentectomy (41.95 ± 28.16)mL(P=0.027). However,the number of lymph node sampling in subsegmentectomy(3.46 ± 2.40)was less than that in pulmonary segmentectomy(4.18 ± 2.49)(P=0.011). At the end of follow-up,there was no metastasis or recurrence in both groups. Conclusion:Pulmonary subsegmentectomy is safe and reliable. It can be applied to treat early-stage small nodules lung cancer. However,the long-term oncological efficiency of pulmonary subsegmentectomy needs further follow-up studies.