Clinical effect and quality control of thoracoscopic anatomical segmental pneumonectomy of early lung cancer

ObjectiveTo explore the effect of thoracoscopic anatomical segmental pneumonectomy on the clinical efficacy of patients with early lung cancer and the quality control of key techniques.

MethodsA retrospective study was conducted on 50 patients with early lung cancer. The patients in the control group (25 cases) underwent thoracoscopic lobectomy, while the patients in the study group (25 cases) underwent thoracoscopic anatomical segmental pneumonectomy and quality control of key techniques, including the strict control of surgical path planning by three-dimensional CT bronchial angiography (3D-CTBA) before operation, the definition of the boundary between pulmonary segments by modified expansion and collapse method, and the use of electric hook, ultrasonic knife and linear cutting suture to perform accurate segmental pneumonectomy. The clinical indexes, 6-minute walking distance, blood routine level, VAS score and complications were compared between the two groups.

ResultsCompared with the control group, the study group had less intraoperative bleeding, less total thoracic drainage, shorter thoracic drainage time and less number of lymph node resection and shorter postoperative hospital stay (P < 0.05 to P < 0.01). There was no significant difference in operation time between the two groups (P>0.05). After operation, the walking distance of 6-minute after operation was shorter than that before operation, and the shortening range was smaller in the study group(P < 0.01);the white blood cell count increased, and the observation group had a small change (P < 0.05). The difference of VAS score after operation was statistically significant between the two groups (P < 0.05). The incidence of postoperative complications in the study group was lower than that in the control group (P < 0.05).

ConclusionsCompared with thoracoscopic lobectomy, thoracoscopic anatomical segmental pneumonectomy can reduce the surgical trauma of patients with early lung cancer, which is helpful to accelerate the rehabilitation of patients. Strictly controlling the core techniques of thoracoscopic anatomical segmental pneumonectomy such as surgery path planning, accurate definition of pulmonary segmental boundary and anatomical separation, giving full play to the advantages of anatomical segmental pneumonectomy can improve the quality of life of patients after operation.