The Journal of Practical Medicine >

2026 , Vol. 42 >Issue 12: 2112 - 2118

DOI: https://doi.org/10.3969/j.issn.1006-5725.2026.12.004

Perioperative Management and Critical Care Support

Clinical effects of thoracoscopic lobectomy and sublobectomy in the treatment of patients with sub-centimeter NSCLC based on perioperative indicators changes and postoperative complications

  • Ruizhen LU ,
  • Peng CHEN ,
  • Xiaoyan ZHANG ,
  • Xiangyu CUI ,
  • Ping XU
Expand
  • Department of Thoracic Surgery，Recovery University Qingdao Central Hospital，Qingdao 266042，Shandong，China

Received date: 2026-03-17

  Online published: 2026-06-30

Fold

Abstract

Objective To explore and compare the clinical efficacy of thoracoscopic lobectomy and sublobectomy in treating patients with sub-centimeter non-small cell lung cancer （NSCLC） （with a maximum tumor diameter ≤ 1 cm）， as well as their influence on perioperative indicators and postoperative complications. Methods From May 2018 to May 2024， 138 patients with sub-centimeter non-small cell lung cancer （NSCLC） were recruited as study subjects for a retrospective cohort analysis. Based on the differences in surgical treatment methods， they were divided into a lobectomy group （video-assisted thoracoscopic lobectomy， 67 cases） and a sublobectomy group （video-assisted thoracoscopic sublobectomy， 71 cases）. The surgical efficacy， perioperative indicators， lung function indicators， and postoperative complications were compared between the two groups， and a statistical analysis was conducted on the occurrence of postoperative complications. Results There were no significant differences in surgical efficacy and postoperative tumor markers between the sublobectomy group and the lobectomy group （P > 0.05）. The sublobectomy group exhibited better perioperative indicators compared to the lobectomy group， with statistical differences （P < 0.05）. The overall incidence of postoperative complications was significantly higher in the lobectomy group than in the sublobectomy group （P < 0.05）. The forced expiratory volume in 1 second （FEV1）， forced vital capacity （FVC）， maximum voluntary ventilation （MVV）， and FEV1/FVC in the sublobectomy group were higher than those in the lobectomy group after surgery （P < 0.05）. No significant difference was found in the 1-year survival rate between the two groups of patients after surgery （P > 0.05）. Conclusions In comparison with video-assisted thoracoscopic lobectomy， video-assisted thoracoscopic sublobectomy for sub-centimeter NSCLC can more significantly shorten the surgical time， reduce the trauma， expedite postoperative recovery， enhance postoperative lung function， and lower the incidence rates of postoperative complications on the premise of ensuring the same short-term oncological efficacy and survival. Therefore， video-assisted thoracoscopic sublobectomy is a safe and effective surgical approach.

Key words： sub-centimeter non-small cell lung cancer; video-assisted thoracoscopy; lobectomy; sublobectomy; clinical efficacy; perioperative indicators; postoperative complications

Cite this article

Ruizhen LU , Peng CHEN , Xiaoyan ZHANG , Xiangyu CUI , Ping XU . Clinical effects of thoracoscopic lobectomy and sublobectomy in the treatment of patients with sub-centimeter NSCLC based on perioperative indicators changes and postoperative complications[J]. The Journal of Practical Medicine, 2026 , 42(12) : 2112 -2118 . DOI: 10.3969/j.issn.1006-5725.2026.12.004

References

[1] 中国临床肿瘤学会非小细胞肺癌专家委员会，PACC专家共识编写小组.EGFR PACC突变晚期非小细胞肺癌诊疗专家共识（2025版）［J］.中华肿瘤杂志， 2025， 47（9）：811-829. doi：10.3760/ cma.j.cn112152-20250529-00247 .
[2] WANG X， SHI J， LIU Z. Nomogram model for the preoperative prediction of spread through air spaces in sub-centimeter non-small cell lung cancer［J］. J Cardiothorac Surg， 2025， 20（1）：218. doi：10.1186/s13019-025-03441-7 .
[3] WU C F， HSIEH M J， FANG Y F， et al. Survival effectiveness of uniport anatomic resections in patients with clinical stage I Lung Cancer： An observation cohort study［J］. Thorac Cancer， 2025， 16（19）：e70169. doi：10.1111/1759-7714.70169 .
[4] TEMEL U， DERDIYOK O， O?UZHAN ?ZYURTKAN M. Awake videothoracoscopic anatomic lung resections for non-small cell lung cancer under thoracic paravertebral block： Clinical experiences［J］. BMC Surg， 2025， 25（1）：265. doi：10.1186/s12893-025-03003-7 .
[5] 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（2018版）［J］. 中华肿瘤杂志， 2018， 40（12）：935-964.doi：10.3760/cma.j.issn.0253-3766. 2018.12.012 .
[6] ZUO Y Q， LIU Q， LI T Z， et al. Computed tomography radiomics of intratumoral and peritumoral microenvironments for identifying the invasiveness of subcentimeter lung adenocarcinomas［J］. BMC Med Imaging， 2025， 25（1）：331. doi：10.1186/s12880-025-01882-z .
[7] WANG Y C， DIAO H X， XU L， et al. Comparison of early functional recovery following triportal robot-assisted and uniportal video-assisted segmentectomy in patients with early-stage Non-Small Cell Lung Cancer： A propensity score-matched analysis［J］. Thorac Cancer， 2025， 16（5）：e70041.doi：10.1111/1759-7714.70041 .
[8] SAJI H， OKADA M， TSUBOI M， et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer （JCOG0802/WJOG4607L）： A multicentre， open-label， phase 3， randomised， controlled， non-inferiority trial［J］. Lancet， 2022， 399（10335）：1607-1617. doi：10.1016/S0140-6736（21）02333-3 .
[9] ZHANG W， ZHU D. Therapeutic effects of single-port thoracoscopic anatomical segmentectomy on early-stage non-small-cell lung cancer［J］. J Minim Access Surg， 2025， 21（1）：19-24.doi：10.4103/jmas.jmas_316_23 .
[10] DURANT A M， PANDIT K， ISLAM N， et al. Subcentimeter pulmonary nodules in patients with clinical stage I non-seminoma： Impact on risk and patterns of disease relapse［J］. Clin Genitourin Cancer， 2025， 23（6）：102448. doi：10.1016/j.clgc.2025.102448 .
[11] HUANG L， PETERSEN R H. Tumour spread through air spaces is a determiner for treatment of clinical stage I non-small cell lung Cancer： Thoracoscopic segmentectomy vs. lobectomy［J］.Lung Cancer， 2025， 201：108438.doi：10.1016/j.lungcan.2025.108438 .
[12] XU Z， LI C， NI Y， et al. Retrospective comparative study of thoracoscopic lobectomy vs. segmentectomy： Enhancing recovery and lung function in early-stage non-small cell lung cancer［J］.Medicine， 2025， 104（47）：e45655-20.doi：10.1097/MD. 0000000000045655 .
[13] 符秋娟，林立尧，曾凯琪，等. 达芬奇机器人辅助手术与视频辅助胸腔镜肺段切除术对早期非小细胞肺癌患者短期疗效的对比研究［J］. 中华实验外科杂志， 2025， 42（10）：2084-2089. doi：10.3760/cma.j.cn421213-20250730-01100 .
[14] 周追求，周宇轩，曾俊，等. 机器人辅助与胸腔镜辅助胸外科手术在非小细胞肺癌中的疗效对比［J］. 中华医学杂志， 2024， 104（34）：3221-3227.doi：10.3760/cma.j.cn112137-20240226-00410 .
[15] ZHANG J， LIU Y. Efficacy of single- and double-hole thoracoscopic lobectomy for treatment of non-small cell lung cancer： A meta-analysis［J］. Am J Transl Res， 2023， 15（5）：3013-3025. PMID： .
[16] DALL'OLIO F G， ABBATI F， FACCHINETTI F， et al.CEA and CYFRA 21-1 as prognostic biomarker and as a tool for treatment monitoring in advanced NSCLC treated with immune checkpoint inhibitors［J］. Ther Adv Med Oncol， 2020， 12（10）：175883592095299. doi：10.1177/1758835920952994 .
[17] SVATON M， BLAZEK J， KRAKOROVA G， et al. Prognostic Role for CYFRA 21-1 in Patients With Advanced-stage NSCLC Treated With Bevacizumab Plus Chemotherapy［J］. Anticancer Res， 2021， 41（4）： 2053-2058.doi：10.21873/anticanres.14974 .
[18] BURESOVA M， BENESOVA L， MINARIK M， et al. Circulating Tumor DNA correlates with Lactate Dehydrogenase， CYFRA 21-1， and CRP levels in patients with advanced NSCLC［J］. J Cancer， 2023， 14（1）：1-8. doi：10.7150/jca.78574 .
[19] KNEUERTZ P J， ABDEL-RASOUL M， D'SOUZA D M， et al. Segmentectomy for clinical stage I non-small cell lung cancer： National benchmarks for nodal staging and outcomes by operative approach［J］. Cancer， 2022， 128（7）：1483-1492.doi：10.1002/cncr.34071 .
[20] MULEY T， SCHNEIDER M A， MEISTER M， et al.CYFRA 21-1， CA 125 and CEA provide additional prognostic value in NSCLC patients with stable disease at first CT scan［J］. Tumour Biol， 2024， 46（s1）：S163-S175.doi：10.3233/TUB-220042 .
[21] BONGIOLATTI S， MUGNAINI G， SALVICCHI A， et al. Completion lobectomy after thoracoscopic segmentectomy on the left side should be approached with thoracotomy［J］. J Thorac Dis， 2025， 17（3）：1561-1569. doi：10.21037/jtd-24-1431 .
[22] 李文彬，杨兵，王鑫洋. 3D重建技术联合肺段切除对非小细胞肺癌患者肿瘤标志物，炎症反应及肺功能的影响［J］. 中国临床解剖学杂志， 2025， 43（4）：471-477.doi：10.13418/j.issn.1001-165x.2025.4.18 .
[23] FU Z， WANG L， HU W， et al. Comparison of the efficacy of subxiphoid and intercostal uniportal video-assisted thoracoscopic surgery in patients with early-stage non-small cell lung cancer［J］. Pak J Med Sci， 2025， 41（2）：359-365.doi：10.12669/pjms.41. 2.11096 .
[24] JIANG H， WU T， QIE P， et al. Comparative analysis of the clinical effects of different thoracoscopic resection in the treatment of Stage I Non-Small Cell Lung Cancer［J］. Pak J Med Sci， 2024， 40（8）：1644-1650. doi：10.12669/pjms.40.8.9124 .
[25] DEWARRAT A， TROXLER R， ABDELNOUR E， et al. Post-operative volume changes in residual lung lobes after thoracoscopic segmentectomy for early stage Non-Small Cell Lung Cancer［J］. Br J Surg， 2025， 112（Sup7）： 072.doi：10.1186/s13019-026-03863-x .
[26] HARTERT M， HUERTGEN M. Portrayal of video-assisted mediastinoscopic lymphadenectomy's range subsequent to its simultaneous use with uniportal VAT-lobectomy for left-sided NSCLC： A case-based perspective［J］. J Cardiothorac Surg， 2023， 18（1）：152. doi：10.1186/s13019-023-02277-3 .
Options
Outlines

/

〈 〉