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

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[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

[中图分类号]R734.2［文献标志码]A[文章编号]1671-7783（2025）06-0528-06 DOI： 10.13312/j.issn.1671-7783.y250102

[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 Afiliated Hospital of Jiangsu University and Jiangsu Province Hospital between January 2O16 and November 2O20. 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 Derioperative deaths.with no recurrence or metastasis bv the end of follow-up in

March 2O25. 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 diferences 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 （204号 mm ，multivariate logistic regresson 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% （204号 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 8-20mm ，the spatial location and diameter of the nodule are key factors influencing the number of pulmonary subsegments involved in the surgery.

[Key words]subsegmentectomy；anatomic sublobar resection； lung cancer；pulmonary nodule ; spatial locaton; surgical indications

随着肺癌筛查普及与早诊技术进步，早期非小细胞肺癌检出率显著提升，JCOG0802、JCOG1211及CALGB140503等研究[1-4]已明确证实，亚肺叶切除术治疗该类病变的肿瘤学疗效确凿可靠。（剩余7861字）