PEEP Combined with Antibiotics for the Reduction of Pulmonary Infection Post-Thoracoscopic Segmentectomy in Stage IA Lung Cancer

This study aimed to evaluate the efficacy of positive end-expiratory pressure (PEEP) combined with drug therapy in preventing postoperative pulmonary infections, providing a basis for optimizing perioperative management in clinical practice. This was a retrospective clinical controlled trial that enrolled 140 patients with stage IA non-small cell lung cancer (NSCLC) admitted between January 2023 and January 2025, all of whom underwent thoracoscopic pulmonary segmentectomy. Patients were divided into a control group (one-lung ventilation [OLV], n = 70) and a study group (PEEP + antibiotics, n = 70) based on the treatment method. The primary outcome measures were the rate of pulmonary infection within 7 days postoperatively and oxygenation function. Secondary outcome measures included hemodynamic indicators, pulmonary ventilation status, postoperative inflammatory markers, clinical prognosis indicators, and incidence of complications. The study demonstrated that PEEP combined with antibiotic intervention significantly reduced the incidence of postoperative pulmonary infection (7.14% in the study group vs. 21.43% in the control group, χ² = 5.833, P = 0.016). Dynamic monitoring revealed that the study group exhibited superior SpO2 decline and oxygenation index (OI) improvement at the end of one-lung ventilation (OLV) and after extubation compared to the control group (P < 0.05), with lower lung ultrasound (LUS) scores in the early postoperative period (0 h, 24 h) (P < 0.05). The study group also showed lower increases in postoperative inflammatory markers (IL-1β, IL-6, CRP) (P < 0.05), shorter extubation time, awakening time, and hospital stay (P < 0.05), and a lower overall incidence of respiratory complications (χ² = 6.295, P = 0.012). PEEP combined with antibiotic pharmacological intervention can effectively reduce the risk of postoperative pulmonary infection in patients with stage IA lung cancer undergoing thoracoscopic pulmonary segmentectomy, alleviate inflammatory responses, promote pulmonary function recovery, and shorten hospital stay, making it a safe and effective perioperative management strategy.