Clinical analysis of the impact of planned sub-lobectomy on pulmonary function

doi:10.3877/cma.j.issn.2095-8773.2017.02.07

Abstract

Abstract:

Objective

To investigate the effect of planned sub-lobectomy on pulmonary function.

Methods

Select 130 patients with lung cancer who underwent surgical treatment of thoracic surgery from January 2012 to May 2016 in Hohhot City, Inner Mongolia. Among them, due to a variety of chronic diseases and lung function can not meet the requirements of lobectomy, the experimental group (72 cases) received planned sub-lobectomy; control group (58 cases) patients received conventional lobectomy. The surgical indicators (including the time of operation, intraoperative blood loss, postoperative hospital stay, postoperative thoracic drainage tube time, postoperative complication rate) and lung function (including tidal volume, forced expiratory volume in first second, percentage of forced expiratory volume in first second to forced vital capacity, minute ventilation volume, arterial oxygen saturation, arterial partial pressure of oxygen, arterial partial pressure of carbon dioxide) of the two groups were observed respectively. Followed up for 6 months to 3 years.

Results

The operation time, thoracic drainage time and postoperative hospital stay were shorter in the experimental group than in the control group. The intraoperative blood loss was less than that of the control group. The incidence of postoperative complications was also lower than that of the control group. The difference was statistically significant (P<0.05). There were no significant differences in the lung function between the experimental group and the control group (P>0.05). But the lung function index of the experiment group was significantly better than that of the control group after 2 weeks (P<0.05). Two groups of patients were followed up for 6 months to 3 years, with no local recurrence.

Conclusions

Compared with lobectomy, the planned sub-lobectomy can preserve the healthy lung tissue on the basis of ensuring the local recurrence rate, the 3-year recurrence-free survival rate, the 3-year survival rate, and ensure the long-term effect; it also reduced the impact on the respiratory function to a minimum. There was no significant decrease in the quality of life with pulmonary function as the main indicators after operation. It is a wise choice for elderly patients with poor heart and lung function or suffering from other chronic diseases.

Key words: Lung cancer, Sub-lobectomy, Pulmonary function, Survival rate

Yu Mao, Wei Guo, Ming Li, Wenhua Zhang. Clinical analysis of the impact of planned sub-lobectomy on pulmonary function[J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2017, 04(02): 101-106.

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分组	例数	手术时间(min)	术中出血量(ml)	胸腔引流时间(d)	术后住院日(d)	术后并发症[例(%)]
实验组	72	110.1±31.4	130.3±50.5	4.5±1.5	6.0±0.3	8(11.1)
对照组	58	170.3±30.1	260.7±90.3	6.3±2.2	14.1±0.3	12(20.6)
检验值	?	t＝23.45	t＝23.67	t＝27.01	t＝29.43	χ²＝24.29
P值	?	<0.05	<0.05	<0.05	<0.05	<0.05

分组	例数	手术时间(min)	术中出血量(ml)	胸腔引流时间(d)	术后住院日(d)	术后并发症[例(%)]
实验组	72	110.1±31.4	130.3±50.5	4.5±1.5	6.0±0.3	8(11.1)
对照组	58	170.3±30.1	260.7±90.3	6.3±2.2	14.1±0.3	12(20.6)
检验值	?	t＝23.45	t＝23.67	t＝27.01	t＝29.43	χ²＝24.29
P值	?	<0.05	<0.05	<0.05	<0.05	<0.05

分组	例数	VT(ml)	FEV₁( L)	FEV₁%	MVV(L)	SaO₂(%)	PaO₂(mmHg)	PaCO₂(mmHg)
实验组	72	460.2±53.2	2.2±0.2	69.4±1.5	68.8±2.9	91±2.3	81±2.1	41±1.7
对照组	58	454.4±43.6	2.2±0.2	71.3±1.2	67.5±2.7	89±2.6	80±2.3	42±1.9
t值	?	5.48	4.64	5.39	4.11	3.87	3.23	4.97
P值	?	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05

分组	例数	VT(ml)	FEV₁( L)	FEV₁%	MVV(L)	SaO₂(%)	PaO₂(mmHg)	PaCO₂(mmHg)
实验组	72	460.2±53.2	2.2±0.2	69.4±1.5	68.8±2.9	91±2.3	81±2.1	41±1.7
对照组	58	454.4±43.6	2.2±0.2	71.3±1.2	67.5±2.7	89±2.6	80±2.3	42±1.9
t值	?	5.48	4.64	5.39	4.11	3.87	3.23	4.97
P值	?	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05

时间	VT(ml)	FEV₁(L)	FEV₁%	MVV(L)	SaO₂(%)	PaO₂(mmHg)	PaCO₂(mmHg)
术前	460.2±53.2	2.2±0.2	69.4±1.5	68.8±2.9	91.0±2.3	81.0±2.1	41.0±1.7
术后	410.2±45.3	2.1±0.2	62.7±2.7	60.9±1.2	90.0±1.9	80.0±2.4	42.0±1.4
t值	6.13	4.71	5.62	3.79	2.95	3.11	5.23
P值	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05

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