Abstract:

Objective

To explore the effects of different surgical methods on chronic cough after lung surgery in patients with peripheral lung adenocarcinoma with maximum tumor diameter ≤2 cm.

Methods

Earlystage lung adenocarcinoma patients who underwent thoracoscopic surgery at the Department of Thoracic Surgery of Provincial Hospital of Anhui Medical University from January 2021 to December 2021 were retrospectively analysed and divided into lobectomy，segmentectomy and wedge groups according to the surgical methods to analyse the effects of lobectomy，segmentectomy and wedge resection on the chronic cough of early-stage lung adenocarcinoma patients in the postoperative period.Logistic regression analysis was used to analyse the risk factors of postoperative chronic cough in patients with early-stage lung adenocarcinoma.

Results

The maximum diameter of tumor in the lobectomy group were larger than that in the segmentectomy and wedge resection groups，and the difference was statistically significant（P＜0.001）.The lung lobe group had more thoracic adhesions than the lung segment and wedge groups（P=0.015）.Patients in the lung lobe group underwent more systematic lymph node dissection（P＜0.001），more upper mediastinal lymph node dissection（P＜0.001），and more subluxation lymph node dissection（P＜0.001） than patients in the lung segment group and wedge group.Patients in the lung lobe group had longer anesthesia time and postoperative banding time than those in the lung segment and wedge groups，with significant differences（P＜0.001，P＜0.001）.Univariate and multifactorial analyses revealed that the tumor was located in the upper lung lobe（P=0.002），lobectomy（P=0.047），systematic lymph node dissection（P＜0.001），upper mediastinal lymph node dissection（P＜0.001），and subglottic lymph node dissection were performed（P＜0.001），and the longer the duration of anesthesia and the duration of post-operative tube banding（P＜0.001，P=0.013） were independent risk influences for chronic cough after lung surgery in patients with early stage lung adenocarcinoma.

Conclusion

Early-stage lung adenocarcinoma patients who underwent lobectomy were more likely to develop postoperative chronic cough after lung surgery than early-stage lung adenocarcinoma patients who underwent sublobar lobectomy.In addition，when the tumor is located in the upper lobe of the lung，mediastinal lymph node dissection is performed，anesthesia time and postoperative time with tubes are long，more attention should be paid to prevent the occurrence of chronic cough after lung surgery after surgery.

Key words: Thoracoscopic lung surgery, Lung adenocarcinoma, Postoperative chronic cough