| Objectives:the ground glass opacity of the lung is well known because it often develops into lung adenocarcinoma.Video assisted thoracoscopic surgery is widely used in clinic field because of its advantages of minimally invasive and good surgical vision.At present,the main surgical methods for the treatment of pulmonary GGO include sub lobectomy(including segmental resection and wedge resection)and lobectomy.Lobectomy plus systematic lymph node dissection is considered to be the standard operation for the treatment of GGO.With the increase of clinical cases,clinical data and materials are gradually enriched.Through postoperative follow-up and analysis of clinical data,many scientists found that sub lobectomy for GGO has a long-term survival rate similar to that of lobectomy,while sub lobectomy has less damage to lung function,that brings better postoperative recovery for postoperative patients.These findings have led to the debate on the choice of GGO operation in clinic.The purpose of this study is to compare the advantages and disadvantages of sub lobectomy and lobectomy in perioperative indicators,3-year overall survival rate and recurrence free survival rate.The ultimate goal is to provide more data on the choice of surgical methods of GGO.Methods:from January 2017 to April 2019,the clinical information of pulmonary GGO patients who underwent surgery in the thoracic surgery of the Affiliated Hospital of Yan’an University were collected and analyzed.According to the major guidelines and consensus,the patients suitable for surgery are screened and operated by the same surgical team.After strict screening,93 patients were finally included in the study.All patients were divided into sub lobectomy group and lobectomy group,including 49 cases in sub lobectomy group and 44 cases in lobectomy group.First,compare the general indexes between the two groups,and then compare the perioperative indexes between the two groups(intraoperative bleeding,operation time,lymph node dissection,postoperative drainage related indexes,length of hospital stay,thoracic drainage tube insertion time,total hospitalization expenses,etc.),postoperative complications,3-year overall survival rate and 3-year recurrence free survival rate.Results:all the enrolled patients completed the operation according to the original plan,without intraoperative death and serious postoperative complications.The comparison between the lobectomy group and the sub lobectomy group showed that the sub lobectomy group was less than the lobectomy group in the comparison of perioperative indexes and the total incidence of postoperative complications.In the comparison of 3-year overall survival rate(97.7% vs 100%,log rank X2 =0.875,P=0.350)and 3-year recurrence free survival rate(93.2% vs 95.9%,log rank X2=0.875,P=0.350),there was no significant difference between the two groups.Subpulmonary lobectomy not only ensures long-term survival,but also reflects the concept of safer and minimally invasive surgery,which is more conducive to the postoperative recovery of patients.Subpulmonary lobectomy is also more suitable for some elderly patients with GGO with general cardiopulmonary function.Conclusion:VATS surgical technique was used in this study to treat GGO.We used sub lobectomy and lobectomy according to different conditions,the 3-year overall survival rate and recurrence free survival rate of the two surgical methods were basically the same.On this basis,sub lobectomy has a small resection range and retains more lung function.And sub lobectomy is superior to lobectomy in the comparison of perioperative indexes,the incidence of postoperative complications was also lower than that of lobectomy.Sub lobectomy embodies the concept of safe and minimally invasive surgery,which is conducive to the postoperative recovery of patients.Its long-term survival rate is similar to that of lobectomy.Subpulmonary lobectomy is also more suitable for some elderly patients with GGO with general cardiopulmonary function. |
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