S2b+S3a联合亚段切除术治疗右上肺后段(S2)和前段(S3)之间肺结节的疗效研究
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江苏省六大人才高峰(WSW?007);吴阶平基金(320.2730.1868)


Efficacy of combined resection of S2b+S3a for pulmonary nodules located between posterior segment(S2) and anterior segment(S3)in the right upper lobe
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    摘要:

    目的:探讨S2b+S3a联合亚段切除术治疗右肺上叶后段(S2)和前段(S3)之间早期非小细胞肺癌等肺结节的可行性与安全性。方法:回顾本中心2015—2020年肺段切除术资料,分析接受S2b+S3a联合亚段切除术的患者结节特征及围术期资料,采用倾向评分匹配获取年龄、性别、结节病理直径相当的右肺上叶切除术病例进行对比研究。结果:共有46例S2b+S3a切除术病例和与之匹配的46例右上叶切除术病例。右上叶组的结节病理恶性程度较S2b+S3a组高(P=0.037),TNM分期更晚(P=0.026),结节深度较S2b+S3a组更深(P=0.005),淋巴结采样站数及采样总数大于S2b+S3a组(P<0.001)。S2b+S3a组的第1天引流量、总引流量及引流管留置时间均小于右上叶组。两组均无围术期死亡,随访终点无复发及死亡。结论:在合理规划下,S2b+S3a联合亚段切除术是治疗右上肺S2和S3之间早期低度恶性非小细胞肺癌等肺结节的一种安全可行的方式。

    Abstract:

    Objective:We aim to explore the feasibility and safety of the S2b+S3a combined subsegmentectomy for pulmonary nodules between S2 and S3 in the right upper lung. Methods:The clinical data of segmentectomy from 2015 to 2020 in our center was cdlected,the nodule characteristics and perioperative data of the patients received S2b+S3a combined resection was analyzed. Propensity score matching was used to select the right upper lobe(RUL)resection cases with comparable age,gender,and pathological nodule diameter. Results:A total of 46 cases of S2b+S3a resection and 46 matched cases of RUL resection were included. The pathologic malignancy of nodules in the RUL group was higher than that in the S2b+S3a group(P=0.037) and the TNM stage was more advanced(P=0.026). The nodules of the RUL group were deeper than that in the S2b+S3a group(P=0.005). The number of lymph node sampled stations and the total number of sampled lymph nodes in the RUL group were larger than those in the S2b+S3a group(P<0.001). In terms of postoperative data,the drainage volume on the first postoperative day,the total drainage volume,and the duration of chest tube drainage of the S2b+S3a group were all smaller than those in the RUL group. There was no perioperative death in both groups and no postoperative recurrence or death at the follow-up endpoint. Conclusion:S2b+S3a combined subsegmentectomy is a safe and feasible method to manage pulmonary nodules such as early non-small cell lung cancer between S2 and S3 under rational planning.

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王 琦,张 伟,潘相龙,何志成,许 晶,李志华,吴卫兵,陈 亮. S2b+S3a联合亚段切除术治疗右上肺后段(S2)和前段(S3)之间肺结节的疗效研究[J].南京医科大学学报(自然科学版),2022,42(5):666-672

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  • 收稿日期:2022-03-19
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  • 在线发布日期: 2022-05-23
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