S^(2)b+S^(3)a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  

Efficacy of combined resection of S^(2)b+S^(3)a for pulmonary nodules located between posterior segment(S^(2))and anterior segment(S^(3))in the right upper lobe

作　　者：王琦[1] 张伟[1] 潘相龙 何志成[1] 许晶[1] 李志华[1] 吴卫兵[1] 陈亮[1] 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)

机构地区：[1]南京医科大学第一附属医院胸外科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2022年第5期666-672,共7页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏省六大人才高峰(WSW-007);吴阶平基金(320.2730.1868)。

摘　　要：目的:探讨S^(2)b+S^(3)a联合亚段切除术治疗右肺上叶后段(S;)和前段(S^(3))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S^(2)b+S^(3)a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S^(2)b+S^(3)a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S^(2)b+S^(3)a组高(P=0.037),TNM分期更晚(P=0.026),结节深度较S^(2)b+S^(3)a组更深(P=0.005),淋巴结采样站数及采样总数大于S^(2)b+S^(3)a组(P<0.001)。S^(2)b+S^(3)a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,S^(2)b+S^(3)a联合亚段切除术是治疗右上肺S;和S^(3)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。Objective:We aim to explore the feasibility and safety of the S^(2)b+S^(3)a combined subsegmentectomy for pulmonary nodules between S^(2)and S^(3)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 S^(2)b+S^(3)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 nodule diameter.Results:A total of 46 cases of S^(2)b+S^(3)a 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 S^(2)b+S^(3)a 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 S^(2)b+S^(3)a 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 S^(2)b+S^(3)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 chest tube drainage of the S^(2)b+S^(3)a 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:S^(2)b+S^(3)a combined subsegmentectomy is a safe and feasible method to manage pulmonary nodules such as early non-small cell lung cancer between S^(2)and S^(3)under rational planning.

关 键 词：联合亚段切除术 S^(2)b+S^(3)a切除术 3D-CTBA 非小细胞肺癌 肺结节 

分 类 号：R734.2[医药卫生—肿瘤]