KEY TAKEAWAYS
- The study aimed to compare segmentectomy and lobectomy by analyzing postoperative cardiopulmonary function and serum tumor markers.
- Results showed segmentectomy better preserves lung function and reduces oxidative stress in NSCLC, with minimal impact on tumor markers.
In patients with early non-small cell lung cancer (NSCLC), single-port thoracoscopic anatomical segmentectomy is a common treatment. However, lung function recovery is slow post-surgery. In contrast, anatomical segmental pneumonectomy, which removes less lung tissue, might lead to faster recovery.
Yiting Shi and the team aimed to compare 2 surgical approaches by analyzing postoperative changes in cardiopulmonary function and serum tumor markers.
Researchers conducted a retrospective analysis of 120 patients with NSCLC from October 2020 to October 2023. Patients were divided into 2 groups based on their surgical intervention.The pulmonary segmentectomy group, which underwent uniportal video-assisted thoracoscopic anatomical pulmonary segmentectomy (n=57), and the lobectomy group, which received uniportal video-assisted thoracoscopic anatomical lobectomy (n=63).
Surgical parameters and perioperative stress indicators were recorded for both groups. Additionally, they compared cardiopulmonary function indicators and serum biomarker levels before and three months after surgery.
The segmentectomy group had a longer operation time and higher intraoperative blood loss compared to the lobectomy group. However, the segmentectomy group had shorter postoperative hospital stays, less chest drainage volume, and shorter drainage tube indwelling times (P< 0.001).
Post-treatment, the segmentectomy group showed higher forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, and maximal voluntary ventilation (MVV) compared to the lobectomy group (P< 0.001).
Additionally, stroke volume (SV) and left ventricular ejection fraction (LVEF) were higher in the segmentectomy group (P< 0.001). There were no significant differences in carbohydrate antigen 50 (CA50), carcinoembryonic antigen (CEA), or cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) levels between the groups after treatment (P> 0.05). After 1 day surgery, levels of epinephrine (E), norepinephrine (NE), and cortisol (Cor) were lower in the segmentectomy group (P< 0.001).
The study concluded that anatomical pulmonary segmentectomy for NSCLC better reduces surgery-induced damage to cardiopulmonary function and lowers perioperative oxidative stress compared to uniportal video-assisted thoracoscopic lobectomy. Both surgical approaches, however, have minimal effects on serum tumor marker levels.
No funding information was provided.
Source: https://pubmed.ncbi.nlm.nih.gov/39186341/
Shi Y, Xiao S. (2024). “Effect of Anatomical Pulmonary Segmentectomy and Lobectomy under Uniportal Video-Assisted Thoracoscopic Surgery on Cardiopulmonary Function and Serum Tumor Markers in Patients with Early-Stage Non-Small Cell Lung Cancer.” Ann Ital Chir. 2024;95(4):593-602. doi:10.62713/aic.3462
