Effects of three kinds of surgical methods on postoperative pulmonary function and exercise capacity in patients with non-small cell lung cancer_West China Medical Journal

Authors：

 GAO Yongshan ¹ , JIANG Weihua ¹ , YANG Yanjun ¹ , ZHANG Zhijie ² , FU Wei ¹ , ZHANG Zhenming ¹ , DONG Yuehua ¹ , WANG Dawei ¹

1. Department of Thoracic and Cardiovascular Surgery, the First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei 075000, P. R. China;
2. Department of Radiology, the 81st Group Army Hospital of the PLA Army, Zhangjiakou, Hebei 075000, P. R. China;

Corresponding?author：

GAO Yongshan, Email: gaoyongshan3333@163.com

Keywords：

Pulmonary function; non-small cell lung cancer; video-assisted thoracic; 6-minute walking distance

DOI：

10.7507/1002-0179.202008242

Video：

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Objective To analyze the effects of different surgical methods on postoperative pulmonary function and exercise capacity in patients with non-small cell lung cancer (NSCLC), so as to explore whether it can effectively improve pulmonary function and promote the recovery of exercise capacity by reducing the number of trocars ports and the resection of normal lung tissues. Methods The clinical data of NSCLC patients who underwent surgery in the First Affiliated Hospital of Hebei North University from January 2016 to June 2019 were collected retrospectively. According to the surgical methods, they were divided into three groups: single utility port video-assisted thoracic surgery (SP-VATS) segmentectomy group, SP-VATS lobectomy group and three port video-assisted thoracic surgery (TP-VATS) lobectomy group. The changes of pulmonary function [forced vital capacity (FVC), forced expiratory volume in one second (FEV₁), peak expiratory flow (PEF), maximal voluntary ventilation (MVV)] and 6-minute walking distance (6MWD) at different time points [1st day before the operation (T₀); 3rd day (T₁), 7th day (T₂), 1st month (T₃), 3rd month (T₄), 6th month (T₅) and 1st year (T₆) after the operation] were compared among the three groups. Results A total of 342 patients were included, including 102 in SP-VATS segmentectomy group, 116 in SP-VATS lobectomy group and 124 in TP-VATS lobectomy group. Except for pathological type and TNM stage (P<0.05), there was no significant difference in general information, preoperative pulmonary function or 6MWD among the three groups (P>0.05). The pulmonary function and 6MWD of the three groups before and after operation were not affected by pathological type or TNM stage (P>0.05). Except at T₆ time point (P>0.05), there were significant differences in postoperative pulmonary function and 6MWD among the three groups at T₁-T₅ time points (P<0.05). Intra group comparison of pulmonary function and 6MWD in the three groups showed that the operation had the least impact on patients in SP-VATS segmentectomy group with the fastest recovery, followed by SP-VATS lobectomy group, and SP-VATS lobectomy group was the worst. Conclusions Video-assisted thoracoscopic for NSCLC can improve pulmonary function and promote the recovery of exercise capacity by reducing the number of trocars ports and the resection of normal lung tissues. However, this advantage is mainly reflected in the early postoperative stage.

Citation： GAO Yongshan, JIANG Weihua, YANG Yanjun, ZHANG Zhijie, FU Wei, ZHANG Zhenming, DONG Yuehua, WANG Dawei. Effects of three kinds of surgical methods on postoperative pulmonary function and exercise capacity in patients with non-small cell lung cancer. West China Medical Journal, 2022, 37(1): 33-39. doi: 10.7507/1002-0179.202008242 Copy

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2.	肖海波, 胡睿, 蔣連勇, 等. 155 例單操作孔解剖性肺段切除的臨床分析. 中國胸心血管外科臨床雜志, 2019, 26(4): 348-352.
3.	Kobayashi N, Kobayashi K, Kikuchi S, et al. Long-term pulmonary function after surgery for lung cancer. Interact Cardiovasc Thorac Surg, 2017, 24(5): 727-732.
4.	Kim HK, Lee YJ, Han KN, et al. Pulmonary function changes over 1 year after lobectomy in lung cancer. Respir Care, 2016, 61(3): 376-382.
5.	李彩偉, 徐美青, 徐廣文, 等. 單孔與三孔胸腔鏡肺部手術后急慢性疼痛的對比研究. 中國肺癌雜志, 2018, 21(4): 279-284.
6.	郭虹, 刁亞利, 范黃新, 等. 全腔鏡下四孔單向式與三孔法解剖性肺葉切除治療早期非小細胞肺癌的臨床回顧性研究. 中國肺癌雜志, 2018, 21(8): 578-582.
7.	Wu CF, Fernandez R, de la Torre M, et al. Mid-term survival outcome of single-port video-assisted thoracoscopic anatomical lung resection: a two-centre experience. Eur J Cardiothorac Surg, 2018, 54(2): 252-259.
8.	王高祥, 熊燃, 吳漢然, 等. 單孔與三孔胸腔鏡治療非小細胞肺癌患者近期結果對比分析. 中國肺癌雜志, 2018, 21(12): 896-901.
9.	Gu Z, Wang H, Mao T, et al. Pulmonary function changes after different extent of pulmonary resection under video-assisted thoracic surgery. J Thorac Dis, 2018, 10(4): 2331-2337.
10.	Jiao P, Sun Y, Tian W, et al. Simple method for distinguishing the intersegmental plane in thoracoscopic lung segmentectomy. Thorac Cancer, 2020, 11(6): 1758-1760.
11.	高永山, 薛占霞, 董躍華, 等. 單操作孔胸腔鏡治療早期周圍型非小細胞肺癌. 中國胸心血管外科臨床雜志, 2016, 23(12): 1132-1135.
12.	Goldstraw P, Chansky K, Crowley J, et al. The IASLC lung cancer staging project: proposals for revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM classification for lung cancer. J Thorac Oncol, 2016, 11(1): 39-51.
13.	江賢亮, 徐美清, 徐世斌. 兩孔法與三孔法胸腔鏡肺葉切除術的對比研究. 中國微創外科雜志, 2018, 18(4): 319-322.
14.	Ye Z, Zhang B, Chen Y, et al. Comparison of single utility port video-assisted thoracoscopic surgery (VATS) and three-port VATS for non-small cell lung cancer. Oncol Lett, 2019, 18(2): 1311-1317.
15.	張艷嬌, 高禹舜. 肺癌胸腔鏡肺葉切除、胸腔鏡肺段切除與開胸肺葉切除術后對肺功能影響的研究. 中國肺癌雜志, 2016, 19(10): 700-704.
16.	王勇, 張勇, 白正忠. 單操作孔完全胸腔鏡與傳統三孔胸腔鏡治療老年肺癌療效對比研究. 陜西醫學雜志, 2019, 48(12): 1670-1672.
17.	Park TY, Park YS. Long-term respiratory function recovery in patients with stageⅠlung cancer receiving video-assisted thoracic surgery versus thoracotomy. J Thorac Dis, 2016, 8(1): 161-168.
18.	Mori S, Shibazaki T, Noda Y, et al. Recovery of pulmonary function after lung wedge resection. J Thorac Dis, 2019, 11(9): 3738-3745.
19.	Tanvetyanon T, Keenan RJ. Recovery of lung function after segmentectomy versus lobectomy for early-stage lung cancer. J Thorac Dis, 2018, 10 (Suppl 18): S2144-S2146.
20.	Nomori H, Shiraishi A, Cong Y, et al. Differences in postoperative changes in pulmonary functions following segmentectomy compared with lobectomy. Eur J Cardiothorac Surg, 2018, 53(3): 640-647.
21.	巨少龍, 高禹舜. 胸腔鏡肺段切除術對肺功能影響的研究進展. 中國肺癌雜志, 2019, 22(8): 537-540.

1. 中華醫學會, 中華醫學會腫瘤學分會, 中華醫學會雜志社. 中華醫學會肺癌臨床診療指南(2019 版). 中華腫瘤雜志, 2020, 42(4): 257-287.
2. 肖海波, 胡睿, 蔣連勇, 等. 155 例單操作孔解剖性肺段切除的臨床分析. 中國胸心血管外科臨床雜志, 2019, 26(4): 348-352.
3. Kobayashi N, Kobayashi K, Kikuchi S, et al. Long-term pulmonary function after surgery for lung cancer. Interact Cardiovasc Thorac Surg, 2017, 24(5): 727-732.
4. Kim HK, Lee YJ, Han KN, et al. Pulmonary function changes over 1 year after lobectomy in lung cancer. Respir Care, 2016, 61(3): 376-382.
5. 李彩偉, 徐美青, 徐廣文, 等. 單孔與三孔胸腔鏡肺部手術后急慢性疼痛的對比研究. 中國肺癌雜志, 2018, 21(4): 279-284.
6. 郭虹, 刁亞利, 范黃新, 等. 全腔鏡下四孔單向式與三孔法解剖性肺葉切除治療早期非小細胞肺癌的臨床回顧性研究. 中國肺癌雜志, 2018, 21(8): 578-582.
7. Wu CF, Fernandez R, de la Torre M, et al. Mid-term survival outcome of single-port video-assisted thoracoscopic anatomical lung resection: a two-centre experience. Eur J Cardiothorac Surg, 2018, 54(2): 252-259.
8. 王高祥, 熊燃, 吳漢然, 等. 單孔與三孔胸腔鏡治療非小細胞肺癌患者近期結果對比分析. 中國肺癌雜志, 2018, 21(12): 896-901.
9. Gu Z, Wang H, Mao T, et al. Pulmonary function changes after different extent of pulmonary resection under video-assisted thoracic surgery. J Thorac Dis, 2018, 10(4): 2331-2337.
10. Jiao P, Sun Y, Tian W, et al. Simple method for distinguishing the intersegmental plane in thoracoscopic lung segmentectomy. Thorac Cancer, 2020, 11(6): 1758-1760.
11. 高永山, 薛占霞, 董躍華, 等. 單操作孔胸腔鏡治療早期周圍型非小細胞肺癌. 中國胸心血管外科臨床雜志, 2016, 23(12): 1132-1135.
12. Goldstraw P, Chansky K, Crowley J, et al. The IASLC lung cancer staging project: proposals for revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM classification for lung cancer. J Thorac Oncol, 2016, 11(1): 39-51.
13. 江賢亮, 徐美清, 徐世斌. 兩孔法與三孔法胸腔鏡肺葉切除術的對比研究. 中國微創外科雜志, 2018, 18(4): 319-322.
14. Ye Z, Zhang B, Chen Y, et al. Comparison of single utility port video-assisted thoracoscopic surgery (VATS) and three-port VATS for non-small cell lung cancer. Oncol Lett, 2019, 18(2): 1311-1317.
15. 張艷嬌, 高禹舜. 肺癌胸腔鏡肺葉切除、胸腔鏡肺段切除與開胸肺葉切除術后對肺功能影響的研究. 中國肺癌雜志, 2016, 19(10): 700-704.
16. 王勇, 張勇, 白正忠. 單操作孔完全胸腔鏡與傳統三孔胸腔鏡治療老年肺癌療效對比研究. 陜西醫學雜志, 2019, 48(12): 1670-1672.
17. Park TY, Park YS. Long-term respiratory function recovery in patients with stageⅠlung cancer receiving video-assisted thoracic surgery versus thoracotomy. J Thorac Dis, 2016, 8(1): 161-168.
18. Mori S, Shibazaki T, Noda Y, et al. Recovery of pulmonary function after lung wedge resection. J Thorac Dis, 2019, 11(9): 3738-3745.
19. Tanvetyanon T, Keenan RJ. Recovery of lung function after segmentectomy versus lobectomy for early-stage lung cancer. J Thorac Dis, 2018, 10 (Suppl 18): S2144-S2146.
20. Nomori H, Shiraishi A, Cong Y, et al. Differences in postoperative changes in pulmonary functions following segmentectomy compared with lobectomy. Eur J Cardiothorac Surg, 2018, 53(3): 640-647.
21. 巨少龍, 高禹舜. 胸腔鏡肺段切除術對肺功能影響的研究進展. 中國肺癌雜志, 2019, 22(8): 537-540.

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Effects of three kinds of surgical methods on postoperative pulmonary function and exercise capacity in patients with non-small cell lung cancer

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