The impact of VATS anatomic segmentectomy on postoperative stress response and respiratory function in early-stage NSCLC patients

Non-small cell lung cancer (NSCLC) is associated with high malignancy, mortality, and recurrence. While early symptoms are subtle, timely surgery significantly improves outcomes. Video-assisted thoracoscopic surgery (VATS) anatomic segmentectomy is an increasingly important technique in early-stage NSCLC management. This study evaluates its effects on postoperative pain, stress response, respiratory function, and quality of life (QOL). This study aims to investigate the impact of VATS anatomic segmentectomy on stress response and pulmonary function in early-stage NSCLC patients. From December 2021 to December 2023, 98 early-stage NSCLC patients were allocated by surgical method: 45 underwent VATS pulmonary lobectomy (control group) and 53 underwent VATS anatomic segmentectomy (observation group). Perioperative outcomes, stress markers (cortisol, growth hormone, adrenocorticotrophic hormone, prostaglandin E2), complications, pain (visual analog scale scores), pulmonary function (forced vital capacity, forced expiratory volume in 1 second, peak expiratory flow, maximal voluntary ventilation, transfer factor for carbon monoxide of the lung), and QOL were compared. Surgical duration and lymph node retrieval did not differ significantly (P > .05). However, the observation group showed less intraoperative bleeding, lower postoperative drainage, shorter extubation time, and reduced hospital stay (P < .05). Preoperative stress markers were similar between groups. Postoperatively, cortisol and prostaglandin E2 were significantly lower in the observation group, while growth hormone and adrenocorticotrophic hormone levels showed no group difference (P < .05). Rates of complications (pneumonia, atelectasis, atrial fibrillation, prolonged air leak, empyema, hoarseness, arrhythmia) were comparable (P > .05). Pain scores at 24, 48, 72 hours, and day 5 were lower in the observation group (P < .05). Preoperative lung function was similar, but at 1 month, the observation group demonstrated higher forced vital capacity, forced expiratory volume in 1 second, peak expiratory flow, maximal voluntary ventilation, and transfer factor for carbon monoxide of the lung (P < .05). QOL was initially comparable, but at 1 and 3 months, the observation group reported significantly better QOL (P < .05). VATS anatomic segmentectomy provides favorable clinical outcomes for early-stage NSCLC. It reduces postoperative stress and pain, enhances lung function recovery, and improves QOL, supporting its value as a surgical option.