| Introduction:To compare the differences in early and long-term physiological function after thoracoscopic lobectomy versus segmental lung resection in patients with NSCLC.Methods:Patients who underwent thoracoscopic lobectomy or segmental lung resection at the First Affiliated Hospital of Nanchang University between April 2022 to September 2022 and had postoperative pathology suggestive of non-small cell lung cancer were recruited and divided into lobar and segmental lung groups according to the surgical procedure.Patients were subjected to pulmonary function tests,6-minute walk test and stair climbing test before,3 days after and 6 months after surgery,respectively,with their informed consent,to analyze the differences between the physiological functions of the two groups and to verify the differences using propensity score matching.Results:A total of 129 patients were recruited in this study,including 57 patients in the lobar group and 72 patients in the lung segment group.The mean age was 57.4 years in the lobar group compared with 55.2 years in the segmental group(p=0.042),while there was no significant difference in gender,BMI,and smoking history.In the analysis of preoperative physiological function indexes,the mean FEV1% of 100.51 was significantly higher in the lobar group than that of 90.82 in the lung segment group(p=0.003),while the rest of the indexes such as FEV1,FVC,FVC%,DLCO,DLCO%,MVV,MVV%,six-minute walking distance,90 floor climbing time,and climbing time of three floors and five floors were not significantly different..Using the loss rate to assess each postoperative physiological function of the patients,the mean loss rate of six-minute walking distance at 3 days postoperatively was 17.53 in the lung segment group was significantly better than 29.00 in the lobe group(p <0.001);six months postoperatively,the mean loss rates of FEV1(10.40 vs12.76),FVC(7.11 vs 8.88),DLCO loss rate(12.37 vs.14.00),6-minute walking distance mean loss rate(4.55 vs.9.04),90-second stair climbing number loss rate(5.68 vs.8.68),and five-story stair climbing time mean loss rate(-13.08 vs.-8.90),were significantly lower than those in the lung segment group,and the differences were statistically significant(P<0.05).Conclusions:1.Postoperative physiological assessment of NSCLS patients using pulmonary function tests,6-minute walk test,and stair climbing test showed that thoracoscopic segmental lung resection had an advantage over lobectomy to some extent;2.three days postoperatively,the 6-minute walk distance and the rate of loss of FEV1 and FVC in patients with thoracoscopic segmental lung resection were significantly lower than those with thoracoscopic lobectomy,while there was no significant difference between the two groups in the stair-climbing test;3.six months after surgery,the loss rate of FEV1 and FVC in patients with thoracoscopic segmental lung resection was lower than that of thoracoscopic lobectomy;the six-minute walk test and the stair climbing test could also well reflect the advantages of segmental lung resection,and the loss rate of six-minute stair climbing distance,height of 90 s stair climbing,and height of five-story stair climbing in patients with segmental lung resection were lower than that of the lobectomy group;4.There was a linear positive association between the 6-minute walking distance of patients 3 days after surgery and the height of 90 s stair climbing before and 3 days after surgery;the 6-minute walking distance six months after surgery was linearly and positively associated with the BMI of patients and the time of climbing five floors,and linearly and negatively associated with the DLCO and DLCO% of patients. |
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