Abstract:

Objective: To investigate the impact of the spatial location of pulmonary nodules (PN) on the extent and efficacy of sublobar resection (SR) based on pulmonary subsegmental anatomical units. Methods: A total of 114 eligible PN patients who received SR were enrolled from the Department of Thoracic Surgery, Taicang First People’s Hospital, between February 2022 and February 2025. Based on the pulmonary subsegmental anatomical units, patients were allocated into three groups stratified by resection scope:Group 1 (single pulmonary subsegmental resection, n=34), Group 2 (combined pulmonary subsegmental resection, n=39), and the Control Group (single pulmonary segmental resection, n=41). Baseline data and PN imaging data of the three groups were collected and statistical analyses were performed to assess the impact of various indicators on the resection scope of SR. In addition, PN recurrence and metastasis in Group 1 and Group 2 were analyzed to compare surgical efficacy among patients with different PN spatial locations. Results: Logistic regression analysis revealed that compared with single pulmonary segmental resection, maximum diameter, lateral location and depth location of PN were influencing factors for single pulmonary subsegmental resection (OR=2.754, 95%CI:1.488-5.097; OR=3.063, 95%CI:1.290-7.273; OR=2.681, 95%CI:1.576-4.561) and the lateral location of PN was an influencing factor for combined pulmonary subsegmental resection (OR=2.833, 95%CI:1.604-5.004). No recurrence or metastasis was observed during follow-up in patients with PN at different lateral and depth location after undergoing different SR procedures. Conclusion: The spatial location of PN is an important factor in determining the scope of SR based on pulmonary subsegmental anatomical units, whereas it has no significant influence on the efficacy of SR.

Key words: Nodule, pulmonary, Spatial location, Sublobar resection, Treatment outcome