Page 70 - 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42卷第5期
·666 · Journal of Nanjing Medical University（Natural Sciences） 2022年5月

·临床研究·

S b+S a联合亚段切除术治疗右上肺后段（S）和前段（S）之间肺
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结节的疗效研究

王 琦，张 伟，潘相龙，何志成，许 晶，李志华，吴卫兵 ，陈 亮 *
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南京医科大学第一附属医院胸外科，江苏 南京 210029

［摘 要］ 目的：探讨S b+S a联合亚段切除术治疗右肺上叶后段（S）和前段（S）之间早期非小细胞肺癌等肺结节的可行性与
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安全性。方法：回顾本中心2015—2020年肺段切除术资料，分析接受S b+S a联合亚段切除术的患者结节特征及围术期资料，
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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S b+S a切除术
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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 S b+S a 组高（P=0.037），TNM 分期更晚（P=
0.026），结节深度较S b+S a组更深（P=0.005），淋巴结采样站数及采样总数大于S b+S a组（P<0.001）。S b+S a组的第1天引流
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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，S b+
S a联合亚段切除术是治疗右上肺S 和S 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。
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［关键词］ 联合亚段切除术；S b+S a切除术；3D⁃CTBA；非小细胞肺癌；肺结节
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［中图分类号］ R734.2 ［文献标志码］ A ［文章编号］ 1007⁃4368（2022）05⁃666⁃07
doi：10.7655/NYDXBNS20220510
Efficacy of combined resection of S b + S a for pulmonary nodules located between
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posterior segment（S）and anterior segment（S）in the right upper lobe
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WANG Qi，ZHANG Wei，PAN Xianglong，HE Zhicheng，XU Jing，LI Zhihua，WU Weibing ，CHEN Liang *
Department of Thoracic Surgery，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029，China
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［Abstract］ Objective：We aim to explore the feasibility and safety of the S b + S a combined subsegmentectomy for pulmonary
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nodules between S and S in the right upper lung. Methods：The clinical data of segmentectomy from 2015 to 2020 in our center was
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cdlected，the nodule characteristics and perioperative data of the patients received S b + S a combined resection was analyzed.
Propensity score matching was used to select the right upper lobe（RUL）resection cases with comparable age，gender，and pathological
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nodule diameter. Results：A total of 46 cases of S b + S a resection and 46 matched cases of RUL resection were included. The
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pathologic malignancy of nodules in the RUL group was higher than that in the S b+S a group（P=0.037）and the TNM stage was more
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advanced（P=0.026）. The nodules of the RUL group were deeper than that in the S b+S a group（P=0.005）. The number of lymph node
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sampled stations and the total number of sampled lymph nodes in the RUL group were larger than those in the S b+S a 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
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chest tube drainage of the S b+S a group were all smaller than those in the RUL group. There was no perioperative death in both groups
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and no postoperative recurrence or death at the follow⁃up endpoint. Conclusion：S b+S a combined subsegmentectomy is a safe and
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feasible method to manage pulmonary nodules such as early non⁃small cell lung cancer between S and S under rational planning.
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［Key words］ combined subsegmentectomy；S b+S a resection；three⁃dimensional computed tomography bronchography and angiogra⁃
phy；non⁃small cell lung cancer；pulmonary nodule
［J Nanjing Med Univ，2022，42（05）：666⁃672］
［基金项目］ 江苏省六大人才高峰（WSW⁃007）；吴阶平基金（320.2730.1868）
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通信作者（Corresponding author），E⁃mail：wuweibing95@126.com；clbright0909@njmu.edu.cn