Pulmonary function changes after sublobar resection in patients with peripheral non-subpleural nodules

Abstract Background In the treatment of peripheral early-staged lung cancer and benign lesions, segmentectomy and wedge resection are both reliable treatment methods. It is debatable that how much pulmonary function will be lost after different sublobar resection in the treatment of early-staged dee...

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Main Authors: Kun-Peng Feng, Zi-Qing Shen, Chun Xu, Cheng Ding, Yu Feng, Xin-Yu Zhu, Bin Pan, Xin-Yu Jia, Jun Zhao, Chang Li
Format: Article
Language:English
Published: BMC 2022-11-01
Series:BMC Surgery
Subjects:
Online Access:https://doi.org/10.1186/s12893-022-01828-0
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author Kun-Peng Feng
Zi-Qing Shen
Chun Xu
Cheng Ding
Yu Feng
Xin-Yu Zhu
Bin Pan
Xin-Yu Jia
Jun Zhao
Chang Li
author_facet Kun-Peng Feng
Zi-Qing Shen
Chun Xu
Cheng Ding
Yu Feng
Xin-Yu Zhu
Bin Pan
Xin-Yu Jia
Jun Zhao
Chang Li
author_sort Kun-Peng Feng
collection DOAJ
description Abstract Background In the treatment of peripheral early-staged lung cancer and benign lesions, segmentectomy and wedge resection are both reliable treatment methods. It is debatable that how much pulmonary function will be lost after different sublobar resection in the treatment of early-staged deep-located peripheral NSCLC (non-small cell lung cancer). The purpose of this study was to explore postoperative pulmonary function changes of sublobar resection in enrolled patients with non-subpleural peripheral nodules. Methods We collected clinical data of patients undergoing VATS (video-assisted thoracoscopic surgery) segmentectomy or wedge resection for single nodule. These nodules were confirmed as peripheral non-subpleural nodules by preoperative 3D imaging. Patients were divided into two groups according to the operation procedure. Demographic characteristics, pulmonary function, postoperative outcomes, and others were collected. All data was gathered at the First Affiliated Hospital of Soochow University. Outcomes after wedge resection were compared with those after segmentectomy resection. Results A total of 88 patients were included in this study, including 46 patients with VATS wedge resection and 42 patients with VATS segmentectomy. No difference was detected when comparing FEV1 (forced expiratory volume in 1 s) loss between these two groups (17.6 ± 2.1%, wedge resection vs. 19.4 ± 5.4%, segmentectomy, P = 0.176). FVC (forced vital capacity) loss (8.7 ± 2.3%, wedge resection vs. 17.1 ± 2.2%, segmentectomy, P < 0.001) and MVV (maximum ventilatory volume) loss (11.5 ± 3.1%, wedge resection vs. 20.6 ± 7.8%, segmentectomy, P < 0.001) in segmentectomy group was significantly higher than those in wedge resection group. Discrepancies were investigated when comparing duration of surgery (70 ± 22 min, wedge resection vs. 111 ± 52 min, segmentectomy, P = 0.0002), postoperative drainage (85 ± 45 mL, wedge resection vs. 287 ± 672 mL, segmentectomy, P = 0.0123), and treatment hospitalization expenses [35148 ± 889CNY, wedge resection vs. 52,502 (38,276–57,772) CNY, segmentectomy, P < 0.0002]. No significant difference was found between air leak time (1.7 ± 0.7 days, wedge resection vs. 2.5 ± 1.7 days, segmentectomy, P = 0.062) and hospitalization time (2.7 ± 0.7 days, wedge resection vs. 3.5 ± 1.7 days, segmentectomy, P = 0.051). Conclusions For patients with peripheral non-subpleural nodules, we observed that patients who underwent wedge resection had less lung function loss than those who underwent segmentectomy when their lung function was reviewed at the 6th month after surgery. Patients undergoing wedge resection had partial advantages over patients with segmental resection in terms of hospitalization cost, operation time and postoperative drainage, etc. Wedge resection, as a treatment for peripheral non-subpleural pulmonary nodules, seemed to have more advantages in preserving patients’ pulmonary function.
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spelling doaj.art-9058b57f09004e55b91cb2d40ab69b462022-12-22T02:31:01ZengBMCBMC Surgery1471-24822022-11-0122111010.1186/s12893-022-01828-0Pulmonary function changes after sublobar resection in patients with peripheral non-subpleural nodulesKun-Peng Feng0Zi-Qing Shen1Chun Xu2Cheng Ding3Yu Feng4Xin-Yu Zhu5Bin Pan6Xin-Yu Jia7Jun Zhao8Chang Li9Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow UniversityDepartment of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow UniversityDepartment of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow UniversityDepartment of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow UniversityDepartment of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow UniversityDepartment of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow UniversityDepartment of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow UniversityDepartment of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow UniversityDepartment of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow UniversityDepartment of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Medical College of Soochow UniversityAbstract Background In the treatment of peripheral early-staged lung cancer and benign lesions, segmentectomy and wedge resection are both reliable treatment methods. It is debatable that how much pulmonary function will be lost after different sublobar resection in the treatment of early-staged deep-located peripheral NSCLC (non-small cell lung cancer). The purpose of this study was to explore postoperative pulmonary function changes of sublobar resection in enrolled patients with non-subpleural peripheral nodules. Methods We collected clinical data of patients undergoing VATS (video-assisted thoracoscopic surgery) segmentectomy or wedge resection for single nodule. These nodules were confirmed as peripheral non-subpleural nodules by preoperative 3D imaging. Patients were divided into two groups according to the operation procedure. Demographic characteristics, pulmonary function, postoperative outcomes, and others were collected. All data was gathered at the First Affiliated Hospital of Soochow University. Outcomes after wedge resection were compared with those after segmentectomy resection. Results A total of 88 patients were included in this study, including 46 patients with VATS wedge resection and 42 patients with VATS segmentectomy. No difference was detected when comparing FEV1 (forced expiratory volume in 1 s) loss between these two groups (17.6 ± 2.1%, wedge resection vs. 19.4 ± 5.4%, segmentectomy, P = 0.176). FVC (forced vital capacity) loss (8.7 ± 2.3%, wedge resection vs. 17.1 ± 2.2%, segmentectomy, P < 0.001) and MVV (maximum ventilatory volume) loss (11.5 ± 3.1%, wedge resection vs. 20.6 ± 7.8%, segmentectomy, P < 0.001) in segmentectomy group was significantly higher than those in wedge resection group. Discrepancies were investigated when comparing duration of surgery (70 ± 22 min, wedge resection vs. 111 ± 52 min, segmentectomy, P = 0.0002), postoperative drainage (85 ± 45 mL, wedge resection vs. 287 ± 672 mL, segmentectomy, P = 0.0123), and treatment hospitalization expenses [35148 ± 889CNY, wedge resection vs. 52,502 (38,276–57,772) CNY, segmentectomy, P < 0.0002]. No significant difference was found between air leak time (1.7 ± 0.7 days, wedge resection vs. 2.5 ± 1.7 days, segmentectomy, P = 0.062) and hospitalization time (2.7 ± 0.7 days, wedge resection vs. 3.5 ± 1.7 days, segmentectomy, P = 0.051). Conclusions For patients with peripheral non-subpleural nodules, we observed that patients who underwent wedge resection had less lung function loss than those who underwent segmentectomy when their lung function was reviewed at the 6th month after surgery. Patients undergoing wedge resection had partial advantages over patients with segmental resection in terms of hospitalization cost, operation time and postoperative drainage, etc. Wedge resection, as a treatment for peripheral non-subpleural pulmonary nodules, seemed to have more advantages in preserving patients’ pulmonary function.https://doi.org/10.1186/s12893-022-01828-0Peripheral lung cancerPulmonary functionSublobar resectionVideo-assisted thoracoscopic surgery
spellingShingle Kun-Peng Feng
Zi-Qing Shen
Chun Xu
Cheng Ding
Yu Feng
Xin-Yu Zhu
Bin Pan
Xin-Yu Jia
Jun Zhao
Chang Li
Pulmonary function changes after sublobar resection in patients with peripheral non-subpleural nodules
BMC Surgery
Peripheral lung cancer
Pulmonary function
Sublobar resection
Video-assisted thoracoscopic surgery
title Pulmonary function changes after sublobar resection in patients with peripheral non-subpleural nodules
title_full Pulmonary function changes after sublobar resection in patients with peripheral non-subpleural nodules
title_fullStr Pulmonary function changes after sublobar resection in patients with peripheral non-subpleural nodules
title_full_unstemmed Pulmonary function changes after sublobar resection in patients with peripheral non-subpleural nodules
title_short Pulmonary function changes after sublobar resection in patients with peripheral non-subpleural nodules
title_sort pulmonary function changes after sublobar resection in patients with peripheral non subpleural nodules
topic Peripheral lung cancer
Pulmonary function
Sublobar resection
Video-assisted thoracoscopic surgery
url https://doi.org/10.1186/s12893-022-01828-0
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