肺癌胸腔镜肺叶切除、胸腔镜肺段切除与开胸肺叶切除术后对肺功能影响的研究

BACKGROUND AND OBJECTIVE: Lung cancer is a malignancy with high morbidity and mortality rates worldwide. Surgery is the preferred treatment for non-small cell lung cancer. This study aims to investigate the effects of video-assisted thoracoscopic surgery (VATS) lobectomy, VATS segmentectomy, and open thoracotomy on pulmonary function in the early postoperative stage and compare the difference among three groups. METHODS: Pulmonary function data of patients were collected from September 2015 to February 2016 in Department of Thoracic Surgical Oncology, Cancer Hospital Chinese Academy of Medical Sciences. The patients were categorized according to operation methods into three groups, namely, VATS segmentectomy, VATS lobectomy, and open thoracotomy groups. Pulmonary function was assessed 1 day before the surgery, 3 days after the surgery, and 3 months after the surgery. Statistical analysis was performed with SPSS 20.0 through single-factor analysis of variance. RESULTS: Pulmonary function 3 days after the surgery was compared among the three groups. There was a significant difference in forced vital capacity (FVC), FVC%, forced expiratory volume in one second (FEV1), FEV1%, peak expiratory flow (PEF), maximal voluntary ventilation (MVV), transfer factor for carbon monoxide of lung (TLCO) and TLCO% (P values were as follows: 0.033, 0.042, 0.029, 0.045, 0.039, 0.021, 0.018, 0.024). The comparison of pulmonary function of 3 groups at the time of 3 months after operation showed that there was a significant difference among three groups in FVC, FVC%, FEV1, FEV1%, PEF, MVV, TLCO, TLCO% (P values were as follows: 0.019, 0.024, 0.044, 0.021, 0.037, 0.029, 0.045, 0.017). CONCLUSION: No matter in the early stage after surgery or at the time of 3 months after surgery, the patients' pulmonary function in VATS segmentectomy is better than the data of VATS lobectomy group, and the pulmonary function data of VATS lobectomy patients recovered better than the open thoracotomy group.