简单段切和复杂段切手术治疗≤2 cm实性肺结节的围术期和远期结局比较

郭松源; 谷志涛; 王奕洋; 罗清泉

doi:10.3971/j.issn.1000-8578.2025.25.0481

简单段切和复杂段切手术治疗≤2 cm实性肺结节的围术期和远期结局比较

Comparison of Perioperative and Long-Term Outcomes Between Simple and Complex Segmentectomies for Treatment of ≤2 cm Solid Pulmonary Nodules

摘要

摘要:
目的根据支气管解剖位置和段平面的不同，肺段切除术可以分为简单段切和复杂段切。本研究探讨不同段切手术对预后的影响。
方法回顾性分析上海交通大学医学院附属胸科医院接受肺段切除术的≤2 cm肺实性结节患者资料，对比手术方式对无复发生存和局部复发的影响。
结果最终纳入复杂段切组57例，简单段切组53例。在未接受辅助治疗的患者中，复杂段切组的5年无复发生存率显著低于简单段切组（69.86% vs. 85.97%，P=0.04），在局部复发率上，复杂段切组显著高于简单段切组（18.75% vs. 4.65%，P=0.003）。
结论对于≤2 cm的肺实性结节，复杂肺段切除术在局部复发控制上存在不足。

Abstract:
Objective To compare the prognostic differences between simple and complex segmentectomies.
Methods We conducted a retrospective cohort analysis of patients with solid pulmonary nodules (≤2 cm) who underwent segmentectomy. Recurrence-free survival (RFS) and local recurrence rates were evaluated.
Results We included57 patients undergoing complex segmentectomy and 53 patients undergoing simple segmentectomy. Among patients who did not receive adjuvant therapy, those in the complex group had a significantly lower five-year RFS than those in the simple group (69.86% vs. 85.97%, P=0.04). Furthermore, the local recurrence rate was significantly higher in the complex group (18.75% vs. 4.65%, P=0.003) than in the simple group.
Conclusion For solid pulmonary nodules (≤2 cm), complex segmentectomy is associated with inferior local control and worse RFS than simple segmentectomy.

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