中国肺癌杂志2025，Vol.28Issue(6)：405-414,10.DOI:10.3779/j.issn.1009-3419.2025.102.23
膈神经冷冻术在电视辅助胸腔镜肺叶切除术中预防持续性肺漏气的应用
Phrenic Nerve Cryotherapy for Preventing Prolonged Air Leak During VATS Lobectomy
摘要
Abstract
Background and objective Video-assisted thoracoscopic surgery(VATS)lobectomy is the primary surgical treatment for lung cancer.A significant factor affecting postoperative recovery is prolonged air leak(PAL).Despite nu-merous clinical strategies could prevent and manage postoperative PAL,its incidence remains high.Phrenic nerve cryotherapy(PNC)temporarily inhibits phrenic nerve function,causing diaphragm elevation,which reduces thoracic cavity volume,en-hances pleural apposition,and mitigates air leakage.This study investigates the efficacy of PNC in preventing postoperative PAL during VATS lobectomy.Methods A total of 108 eligible lung cancer patients who underwent surgery at the Department of Thoracic Surgery,The Affiliated Hospital of Inner Mongolia Medical University,from June 2023 to January 2025,were enrolled and randomly assigned to the control group(n=54)and the experimental group(n=54).The patients in both the two groups received VATS lobectomy and systematic lymph node dissection,with the experimental group also undergoing PNC during the operation.The baseline characteristics,intraoperative,postoperative indicators and dynamic changes in air leakage between the two groups were compared.Results The baseline clinical characteristics were comparable between the two groups(P＞0.05).The incidence of pulmonary air leakage at 24 h after surgery(31.5％vs 29.6％)and the incidence of postoperative PAL(20.4％vs 14.8％)showed no significant differences between the two groups(P＞0.05).The intraoperative air leak test to 24 hours after surgery revealed that air leakage ceased in 8 cases(32.0％)in the control group,compared to 14 cases(46.7％)in the experi-mental group.Moreover,during the progression from air leakage at 24 hours post-surgery to postoperative PAL,air leakage ceased in 6 cases(35.3％)in the control group and 8 cases(50.0％)in the experimental group,with a statistically significant dif-ference(P＜0.001).Compared to the control group,the patients in the experimental group exhibited more pronounced postop-erative diaphragmatic elevation that recovered to a slightly higher than preoperative level by 3 mon after surgery.Conclusion The combination of PNC and active lung repair can serve as an important intervention for patients at high risk of intraoperative air leakage,reducing the occurrence of postoperative PAL.关键词
肺肿瘤/电视辅助胸腔镜手术/膈神经冷冻术/持续性肺漏气Key words
Lung neoplasms/Video-assisted thoracoscopic lobectomy/Phrenic nerve cryotherapy/Prolonged air leak引用本文复制引用
孟庆宇,吴永坤,王宇飞,郭占林..膈神经冷冻术在电视辅助胸腔镜肺叶切除术中预防持续性肺漏气的应用[J].中国肺癌杂志,2025,28(6):405-414,10.基金项目
本研究受内蒙古草原英才项目(No.CYYC5057)资助 This study was supported by the grant from Inner Mongolia Grassland Talent Project(No.CYYC5057)(to Zhanlin GUO). （No.CYYC5057）
