Single-port thoracoscopic complex vs simple lung segmentectomy: Comparative outcomes and feasibility

Complex lung segmentectomy, although effective for early-stage lung cancer, is less widely adopted because of its technical complexity.

This study aimed to compare perioperative outcomes, quality of life (QoL), and survival between complex and simple lung segmentectomy performed using single-port thoracoscopy to determine its clinical feasibility.

This retrospective analysis screened 218 patients; after exclusions, 210 patients underwent complex (n = 100) or simple (n = 110) segmentectomy at Zhanjiang Central Hospital. Propensity score matching resulted in 92 patients per group. Single-port thoracoscopic surgery was performed, and perioperative outcomes, complications, QoL assessed using the 36-Item Short Form Health Survey (SF-36), and survival evaluated using Kaplan-Meier curves were analyzed. Statistical analyses were performed using t-tests, χ2 tests, and log-rank tests (p < 0.05).

Complex segmentectomy was associated with longer operative time, greater postoperative drainage, and longer hospital stays (p < 0.001). Cough (60.87% vs 32.61%; p = 0.007) and air leakage (54.35% vs 19.57%; p < 0.001) were more common in the complex group. No significant differences were observed in postoperative lung function, other complications, such as infection or arrhythmia, or QoL at 6 months (p = 0.071). Survival curves showed comparable prognosis (p = 0.860).

Despite increased perioperative demands, complex lung segmentectomy achieves lung function, QoL, and survival outcomes similar to those of simple segmentectomy, supporting its role in the treatment of early-stage lung cancer. These findings support its broader application in specialized settings and may inform optimized surgical approaches.