Efficacy And Long-term Prognosis Of Thoracoscopic Segmentectomy And Lobectomy In The Treatment Of Early Non-small Cell Lung Cancer

Objective To compare the postoperative quality of life and long-term prognosis of thoracoscopic segmentectomy and lobectomy in the treatment of early non-small cell lung cancer(NSCLC).Methods 340 cases of early NSCLC patients admitted to our hospital from January 2015 to December 2017 were retrospectively analyzed.It can be divided into control group(88 cases)and observation group(88 cases)by using 1:1Propensity Score Matching method(Propensity Score Matching,PSM).Control group adopts a treatment of thoracoscopic lobectomy,while observation group adopts a treatment of thoracoscopic segmentectomy.Matching on two groups of patients after general information(age,gender,lymph node dissection,history of smoking,drinking,history of allergies,history of cough).The selection of two groups of patients with good balance(P > 0.05)integrated after comparison.The perioperative indexes,quality of life one month after surgery,3-year recurrence free survival(RFS)and overall survival(OS)of patients in the two groups were compared.Results Perioperative indicators: Compared with control group,the chest tube indwelling time and hospitalization time of observation group is shorter,chest total flow less,but there was no statistically significant difference(P > 0.05),the incidence of pulmonary infection,pulmonary air leakage and hemorrhage is low,there was no statistically significant difference(P > 0.05),the overall complication rate is low,the difference was statistically significant(P < 0.05).Postoperative quality of life: Compared with control group,the observation group has better physical function,role function,social function and overall health level(P < 0.05),and less difficulty in anhelation and economic(P <0.05),cough,anhelation is worse,the difference was statistically significant(P < 0.05),haemoptysis,mouth pain,difficulty swallowing,hands and feet hurt,hair loss,chest pain,hand or shoulder pain and other parts of the pain had no obvious difference(P >0.05).There were no significant differences in cognitive function,emotional function,pain,fatigue,insomnia,loss of appetite,nausea,vomiting,constipation and diarrhea between 2 groups(P > 0.05).In terms of long-term prognosis,patients in both groups were followed up for 3 years.The results showed that the RFS of the observation group was 90.90%(80/88),and the RFS of the control group was 93.20%(82/88).The RFS of the observation group was lower than that of the control group,but the difference between the two groups was not statistically significant(χ2=0.31,P > 0.05).The OS was 98.90%(87/88)in the observation group and 94.30%(83/88)in the control group at 3 years after operation.The OS in the observation group was higher than that in the control group,but there was no significant difference between the two groups(χ2=2.761,P > 0.05).Conclusion Pulmonectomy and lobectomy in the treatment of early NSCLC patients have similar long-term prognosis,but the former can reduce the incidence of postoperative complications and achieve a higher postoperative quality of life.If the general condition of the patient permits,segmentectomy is a valuable alternative treatment strategy with a certain promotion value.