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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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.	李彩伟, 徐美青, 徐广文, 等. 单孔与三孔胸腔镜肺部手术后急慢性疼痛的对比研究. 中国肺癌杂志, 2018, 21(4): 279-284.
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8.	王高祥, 熊燃, 吴汉然, 等. 单孔与三孔胸腔镜治疗非小细胞肺癌患者近期结果对比分析. 中国肺癌杂志, 2018, 21(12): 896-901.
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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, 董跃华, 等. 单操作孔胸腔镜治疗早期周围型非小细胞肺癌. 中国胸心血管外科临床杂志, 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.	江贤亮, 徐美清, 徐世斌. 两孔法与三孔法胸腔镜肺叶切除术的对比研究. 中国微创外科杂志, 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.	张艳娇, 高禹舜. 肺癌胸腔镜肺叶切除、胸腔镜肺段切除与开胸肺叶切除术后对肺功能影响的研究. 中国肺癌杂志, 2016, 19(10): 700-704.
16.	王勇, 张勇, 白正忠. 单操作孔完全胸腔镜与传统三孔胸腔镜治疗老年肺癌疗效对比研究. 陕西医学杂志, 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.	巨少龙, 高禹舜. 胸腔镜肺段切除术对肺功能影响的研究进展. 中国肺癌杂志, 2019, 22(8): 537-540.

1. 中华医学会, 中华医学会肿瘤学分会, 中华医学会杂志社. 中华医学会肺癌临床诊疗指南(2019 版). 中华肿瘤杂志, 2020, 42(4): 257-287.
2. 肖海波, 胡睿, 蒋连勇, 等. 155 例单操作孔解剖性肺段切除的临床分析. 中国胸心血管外科临床杂志, 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. 李彩伟, 徐美青, 徐广文, 等. 单孔与三孔胸腔镜肺部手术后急慢性疼痛的对比研究. 中国肺癌杂志, 2018, 21(4): 279-284.
6. 郭虹, 刁亚利, 范黄新, 等. 全腔镜下四孔单向式与三孔法解剖性肺叶切除治疗早期非小细胞肺癌的临床回顾性研究. 中国肺癌杂志, 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, 吴汉然, 等. 单孔与三孔胸腔镜治疗非小细胞肺癌患者近期结果对比分析. 中国肺癌杂志, 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, 董跃华, 等. 单操作孔胸腔镜治疗早期周围型非小细胞肺癌. 中国胸心血管外科临床杂志, 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. 江贤亮, 徐美清, 徐世斌. 两孔法与三孔法胸腔镜肺叶切除术的对比研究. 中国微创外科杂志, 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. 张艳娇, 高禹舜. 肺癌胸腔镜肺叶切除、胸腔镜肺段切除与开胸肺叶切除术后对肺功能影响的研究. 中国肺癌杂志, 2016, 19(10): 700-704.
16. 王勇, 张勇, 白正忠. 单操作孔完全胸腔镜与传统三孔胸腔镜治疗老年肺癌疗效对比研究. 陕西医学杂志, 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. 巨少龙, 高禹舜. 胸腔镜肺段切除术对肺功能影响的研究进展. 中国肺癌杂志, 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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