江苏大学学报（医学版）2025，Vol.35Issue(6)：528-533,6.DOI:10.13312/j.issn.1671-7783.y250102
肺结节空间位置对肺亚段解剖单元亚肺叶切除术范围及疗效的影响
Impact of spatial location of pulmonary nodules on the resection scope and efficacy of sublobar resection based on pulmonary subsegmental anatomical units
摘要
Abstract
Objective:To explore the impact of pulmonary nodule spatial location on the number of resected subsegments and surgical outcomes in anatomic sublobar resection.Methods:A retrospective analysis was conducted on 157 patients with pulmonary nodules who underwent"nodule-centric,subsegment-as-unit"surgery at the Affiliated Hospital of Jiangsu University and Jiangsu Province Hospital between January 2016 and November 2020.Based on the surgical approach,patients were divided into four groups:single subsegmentectomy(28 cases),combined subsegmentectomy(42 cases),single segmentectomy(66 cases),and single segmentectomy combined with adjacent subsegmentectomy(21 cases).Preoperative,intraoperative,and postoperative data were compared among the four groups.Results:There were no perioperative deaths,with no recurrence or metastasis by the end of follow-up in March 2025.Univariate analysis showed significant differences among the four groups in terms of maximum radiographic diameter and transverse location(relationship to the intersegmental vein)(P=0.022,P＜0.001,respectively).No significant differences were found in other baseline data such as gender,age,and smoking history(all P＞0.05).For intrasegmental nodules with a diameter of 8-20 mm,multivariate logistic regression analysis indicated that,compared to single segmentectomy,the performance of single subsegmentectomy was closely associated with the nodule's depth position(OR=7.224,95％CI:1.084-48.132,P=0.041)and maximum radiographic diameter(OR=0.068,95％CI:0.009-0.503,P=0.008).Conclusion:The surgical strategy using the pulmonary subsegment as the anatomic unit is safe and feasible for treating ground-glass-opacity dominant pulmonary nodules.For intrasegmental pulmonary nodules with a diameter of 8-20 mm,the spatial location and diameter of the nodule are key factors influencing the number of pulmonary subsegments involved in the surgery.关键词
肺亚段切除术/解剖性亚肺叶切除术/肺癌/肺结节/空间位置/手术适应证Key words
subsegmentectomy/anatomic sublobar resection/lung cancer/pulmonary nodule/spatial locaton/surgical indications分类
医药卫生引用本文复制引用
黄晶晶,戚海峰,林进星,彭浪,周沪程,王俊,李峰..肺结节空间位置对肺亚段解剖单元亚肺叶切除术范围及疗效的影响[J].江苏大学学报（医学版）,2025,35(6):528-533,6.基金项目
吴阶平医学基金会资助项目(Hx202101) （Hx202101）
镇江市社会发展重大科技计划项目(SH2019063) （SH2019063）
镇江市社会发展面上项目(SH2023079) （SH2023079）
