Study On Determining The Appearance Speed Of Segmental Plane By Improved Expansion And Collapse Method In Pneumonectomy

Objective(s):As small pulmonary nodules are detected in lung cancer screening,anatomic segmentectomy is becoming more widely used,and the modified dilatation-collapse method is most commonly used to identify intersegmental planes method,but the appearance time of the plane varies during the application of this method during the operation.In this paper,according to the speed of the intersegmental plane,the patients were divided into two groups of fast and slow,and by comparing the clinical data and pulmonary function indexes of the two groups of patients,the relevant factors affecting the speed of the intersegmental plane formed by the improved inflation-collapsing method were discussed,in order to provide The method of determining the optimal intersegmental plane during the operation provides some clinical references.Methods:Retrospective analysis of the case data and preoperative auxiliary examination results of patients who underwent VATS segmentectomy in the Department of Thoracic Surgery of The Second Affiliated Hospital of Kunming Medical University from January 2021 to November 2022 and obtained the intersegmental plane using the modified-expansion and collapse method will be eligible for inclusion The standard 138 patients were divided into two groups with 15 minutes as the waiting time boundary between segments.The slow group consisted of 70 patients whose waiting time exceeded 15 minutes,and the fast group consisted of 68 patients whose waiting time was less than 15 minutes.SPSS26.0 The software system conducts statistical analysison the relevant factors of the two groups,and analyzes the differences in relevant indicators between the two groups of patients.Results:All patients were obtained by the modified dilatation-collapse method to obtain intersegmental planes.The average waiting time in the fast group was(12.07±2.1)(9.97-14.17)min,and the average waiting time in the slow group was(19.3±3.82)(15.48 ~23.12)min.The average age of the fast group was lower than that of the slow group,which were(51.9±12.0)(39.9-63.9)years old and(58.1±12.1)(46-70.2)years old respectively,and the difference was statistically significant(P=0.003).Six cases(8.8%)of complex lung segments were resected in the fast group,and 20 cases(28.6%)were resected in the slow group,and the difference was statistically significant(P=0.03).There were 2 cases(2.9%)of pleural adhesions in the fast group and 9 cases(12.9%)in the slow group,the difference was statistically significant(P=0.032).In the analysis of pulmonary function indicators,VCMAX(maximum vital capacity),FVC(forced vital capacity),FEV1/FVC(forced respiratory volume in 1 second/forced vital capacity),RV/TLC(residual volume/total lung capacity)and other indicators have statistical There were no statistical differences(P<0.05).In terms of sex,BMI,smoking history,history of hypertension,history of diabetes,surgical site(left/right,upper/lower),FEV1(forced expiratory volume in one second),MMEF(mid-term forced expiratory flow velocity),PEF(peak expiratory flow),MVV(maximum voluntary minute ventilation),IC(inspiratory volume)and other indicators had no statistical difference(P>0.05).Conclusion:1.It is reliable and feasible to use the modified dilatation collapse method to identify the intersegmental plane in segmental resection.2.For young patients with better lung function,intersegmental plane exposure is faster and more effective.3.For older patients,patients with severe thoracic adhesion,and patients with poor lung function,such as patients with severe emphysema and patients with complex lungsegmental resection,the intersegmental plane is less effective or the waiting time is longer.