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Preservation of pulmonary branches of vagus nerve in minimally invasive surgery for lung cancer

In minimally invasive surgery for lung cancer, the pulmonary branches of vagus nerve were severed

In minimally invasive surgery for lung cancer, the experimental group retained the pulmonary branches of vagus nerve

In minimally invasive surgery，Vagus nerve preservation

In minimally invasive surgery for lung cancer, the control group did not retain the vagus nerve.

In minimally invasive surgery，Vagus nerve is not preserved

Wenli Wang, Master's degree

Yongxin zhou, Doctor

Wenli Wang, Master

Shaorui Gu, scholor

Through prospective, randomized and controlled clinical study, patients with early lung cancer who do not need lymph node dissection according to routine diagnosis and treatment were selected. The feasibility and safety of preserving vagal pulmonary branch intact during minimally invasive surgery were compared with traditional minimally invasive surgery, and the feasibility and safety of preserving vagal pulmonary branch intact during minimally invasive surgery were clarified. The effect of preserving pulmonary branches of vagus nerve in minimally invasive surgery of early lung cancer on preventing or reducing pulmonary complications after operation was evaluated by main observation indexes (incidence of pulmonary complications) and secondary evaluation indexes. It will provide a safer, simpler and more effective new technology for patients with early lung cancer undergoing minimally invasive surgery, and provide a basis for the popularization of this new technology.

According to the suggestion of statistical experts and the minimum sample size, 120 IA1-2 patients who are going to undergo thoracoscopic lung surgery were selected according to the criteria of admission and exclusion. The risk and benefit were informed and the informed consent of the subjects was signed. The patients were numbered and randomly divided into two groups: group A with vagus nerve preservation during minimally invasive surgery and group B with traditional minimally invasive surgery for early lung cancer. The incidence of pulmonary complications within 5 weeks after operation (see the evaluation criteria for details), operation time, intraoperative bleeding volume, postoperative drainage volume, postoperative mortality, incidence of cardiovascular complications, rate of re-tracheal intubation, rate of re-admission to ICU, duration of stay in ICU, hospitalization costs were observed. Statistical analysis and evaluation of the safety of preserving pulmonary branches of vagus nerve in minimally invasive surgery and the effectiveness of preventing or reducing pulmonary complications after minimally invasive surgery.

120 patients were divided into two groups. One group retained the pulmonary vagus nerve and the other group severed the vagus nerve.

Clinical Evaluation of Vagal Nerve Preservation in Minimally Invasive Surgery for Early Lung Cancer

Clinical Application of Vagus Nerve Preservation in Minimally Invasive Surgery for Early Lung Cancer

(1) dry cough lasting no less than 2 weeks after pneumonectomy; (2) no obvious abnormalities in chest X-ray; (3) excluding drug factors such as postnasal drip syndrome, bronchial asthma and ACEI

Postoperative pneumonia should be considered if there are three or more of the following indicators:

1. Fever occurred 72 hours after operation, and the body temperature increased again within T \> 38 C or 72 hours.
2. Leukocyte count increased (\>12-15\*109/L) or increased again after the leucocyte count returned to normal value, exceeding 10\*109/L;
3. Chest imaging showed consolidation of lung tissue or increasing patchy shadow;
4. cough up purulent sputum or sputum culture positive;

If it contains 4, only one of the other items can be considered as a respiratory consultation to determine pulmonary infection, and need to replace antibiotics or prolong the use of antibiotics.

(1) Imaging findings suggest atelectasis or consolidation of the lungs; (2) signs of dyspnea; (3) decreased oxygen saturation to below 90%.

Re-catheterization was needed; dyspnea symptoms; and drainage time was longer than 15 days.

Postoperative cardiovascular complications

Spots Global Cancer Trial Database for in minimally invasive surgery，vagus nerve is not preserved