Pulmonary function changes after sublobar resection in patients with peripheral non-subpleural nodules.

Area of Science:

• Thoracic Surgery
• Pulmonary Medicine
• Surgical Oncology

Background:

• Sublobar resection, including segmentectomy and wedge resection, are standard treatments for early-stage lung cancer and benign lesions.
• The impact of different sublobar resection techniques on pulmonary function in patients with non-small cell lung cancer (NSCLC) remains a subject of debate.
• This study focuses on comparing postoperative pulmonary function changes following segmentectomy versus wedge resection for non-subpleural peripheral nodules.

Purpose of the Study:

• To compare postoperative pulmonary function changes between VATS segmentectomy and wedge resection for peripheral non-subpleural nodules.
• To evaluate differences in outcomes such as operation time, postoperative drainage, hospitalization costs, and recovery time.
• To determine which surgical approach offers better preservation of lung function at six months post-surgery.

Main Methods:

• A retrospective study involving 88 patients who underwent VATS segmentectomy or wedge resection for single, peripheral, non-subpleural nodules.
• Patients were categorized into two groups based on the surgical procedure: wedge resection (n=46) or segmentectomy (n=42).
• Collected data included demographic characteristics, preoperative 3D imaging, pulmonary function tests (FEV1, FVC, MVV), and postoperative outcomes.

Main Results:

• No significant difference in Forced Expiratory Volume in 1 second (FEV1) loss was observed between wedge resection and segmentectomy groups (17.6% vs 19.4%).
• Segmentectomy resulted in significantly greater loss of Forced Vital Capacity (FVC) (17.1% vs 8.7%) and Maximum Ventilatory Volume (MVV) (20.6% vs 11.5%) compared to wedge resection.
• Segmentectomy was associated with longer operation times, increased postoperative drainage, and higher hospitalization expenses compared to wedge resection.

Conclusions:

• Wedge resection demonstrated superior preservation of pulmonary function (FVC and MVV) at six months post-surgery compared to segmentectomy for peripheral non-subpleural nodules.
• Wedge resection also showed advantages in terms of reduced operation time, lower postoperative drainage, and decreased hospitalization costs.
• Wedge resection appears to be a more advantageous surgical option for preserving pulmonary function in patients with peripheral non-subpleural pulmonary nodules.