Clinical Feasibility Analysis Of Video-assisted Thoracoscopic Pulmonary Vessel/bronchial Sleeve Resection For Central Non-small Cell Lung Cancer: Comparison Of Video-assisted Thoracoscopic Pulmonary Vessel/bronchial Sleeve Resection With Traditional Thora

Objective:To investigate the clinical efficacy and safety of Video-assisted Thoracoscopic pulmonary angiobronchial sleeve resection in the treatment of central non-small cell lung cancer(NSCLC).The advantages of Video-assisted Thoracoscopic pulmonary angiobronchial sleeve resection were analyzed to select the most suitable surgical method for lung cancer patients.Methods:Collected in December 2014 to December 2019,respectively,in the second hospital of shanxi medical university and tumor hospital of Shanxi Province under Video-assisted Thoracoscopy pulmonary vascular bronchial sleeve resection treatment of type in the middle of the 35 patients with non-small cell lung cancer(group A),at the same time random selection in December 2014-December 2019 in the second hospital of shanxi medical university or tumor hospital of Shanxi Province chest downward in the middle of the pulmonary vascular bronchial sleeve resection treatment of type in patients with non-small cell lung cancer(70 cases(group B)as A control.The intraoperative time,intraoperative blood loss,lymph node dissection,postoperative complications,total thoracic drainage,postoperative indwelling time,postoperative pain score,and postoperative hospital stay were compared in group AB.Comparison of recent(1 month,6 months and 1 year)quality of life and 3 years survival rate in group AB.Results:There was statistical difference in the operation time [(228.1±24.7)h vs.(175.0±23.7)h,P=0.02],postoperative complication rate(28.6% vs.34.3%,P=0.04),postoperative pain score at 24 h [(3.61±3.5)points vs.(5.93±2.0)points,P=0.03] and postoperative indwelling chest tube time [(5.0±2.9)d vs.(8.4±2.1)d,P=0.04] between the two groups.There was no statistical difference in the intraoperative blood loss[(182.5±36.9)h vs.(189.8±27.5)h,P=0.34],number of lymph node dissections [(11.1±2.6)h vs.(12.3±1.9),P=0.49],early postoperative mortality(2.9% vs.4.3%,P=0.31),total thoracic drainage volume at 24 h after surgery [(346.8±91.1)ml vs.(329.8±101.4)ml,P= 0.27],postoperative hospital stay [(7.9 ±4.2)d vs.(8.5±3.4)d,P=0.39] and3-year postoperative survival rate(68.6% vs.72.9%,P=0.82)between the two groups.Conclusion:On the premise of satisfying the clinical surgical indications,Video-assisted Thoracoscopic pulmonary angiobronchial sleeve resection for the treatment of central non-small cell lung cancer is safe,effective and feasible.Compared with thoracotomy,the postoperative complications are less,the short-term postoperative clinical effect(within 6 months)is better,the physical recovery is faster,and the quality of life is higher.And the 3-year survival rate was similar to that of open-heart surgery.