Page 88 - 南京医科大学学报自然科学版

南京医科大学学报（自然科学版） 第41卷第8期
·1190 · Journal of Nanjing Medical University（Natural Sciences） 2021年8月

·临床医学·

肺亚段切除术对比肺段切除术治疗早期小结节肺癌的安全性

及短期疗效分析

刘 强，李志华，王 俊，闻 伟，朱 全，陈 亮 *

南京医科大学第一附属医院胸外科，江苏 南京 210029

［摘 要］ 目的：对比肺段切除术，分析肺亚段切除术治疗肺小结节病变的安全性及短期疗效。方法：回顾性分析2020年4—
12月于南京医科大学第一附属医院胸外科行肺段切除术或者肺亚段切除术的肺小结节患者367例。根据手术方式将其分为
肺亚段切除术组（107例）和肺段切除术组（260例），对比两组围术期临床资料和早期疗效。结果：肺亚段切除术组病灶切缘为
（2.58±0.94）cm，拔管时间（2.56±0.85）d，术后住院天数（3.50±1.07）d。与肺段组相比，病灶切缘（P=0.446）、拔管时间（P=
0.639）、术后住院天数（P=0.267）、病理诊断（P=0.337）及肺部漏气、声音嘶哑、发热、心律失常等并发症发生率等方面差异均无
统计学意义。肺亚段切除术组的手术时间［（147.21±37.97）min］长于肺段切除术组［134.66±40.70）min，P=0.007］，术中出血量
［（50.42±38.59）mL］多于肺段组［（41.95±28.16）mL，P=0.027］，而淋巴结采样数［（3.46±2.40）］个少于肺段组［（4.18±2.49）个，P=
0.011］。随访终点两组均无转移和复发。结论：肺亚段切除术安全可靠，可用于早期小结节肺癌的治疗，但其远期肿瘤学疗效
仍需进一步的随访研究。
［关键词］ 肺亚段切除术；肺段切除术；非小细胞肺癌
［中图分类号］ R734.2 ［文献标志码］ A ［文章编号］ 1007⁃4368（2021）08⁃1190⁃06
doi：10.7655/NYDXBNS20210813

Analysis of the safety and short ⁃ term efficacy of pulmonary subsegmentectomy versus
segmentectomy in the treatment of early⁃stage small nodular lung cancer

*
LIU Qiang，LI Zhihua，WANG Jun，WEN Wei，ZHU Quan，CHEN Liang
Department of Thoracic Surgery，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029

［Abstract］ 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.
［Key words］ pulmonary subsegmentectomy；pulmonary segmentectomy；non⁃small cell lung cancer
［J Nanjing Med Univ，2021，41（08）：1190⁃1195］
［基金项目］ 江苏省重点研发计划（BE2018746）
∗
通信作者（Corresponding author），E⁃mail：clbright0909@njmu.edu.cn