To evaluate postoperative changes of pulmonary function of small airway in patients undergoing video-assisted thoracic surgery (VATS) segmentectomy and wedge resection through spirometry.

A total of 124 patients underwent thoracoscopic segmentectomy and lung wedge resection in our hospital from Jan. 2021 to Jun. 2021, including 64 cases of anatomical segmentectomy (segmentectomy group) and lung wedge resection (wedge group) ) 60 cases. By comparing the changes between MEF25% and MEF50% and MEF75%/25% in each group before operation and 1 week, 1 month, 3 months and 6 months after surgery, the effects of segmentectomy and lung wedge resection on pulmonary small airway function was clarified.

After the operation, the small airway pulmonary function of the wedge resection group and the anatomic segmentectomy group were decreased compared to non-surgical; the small airway pulmonary function of the wedge resection group and the anatomic segmentectomy group was significantly improved at 1 month after the operation, and the indexes in the wedge resection group recovered better than those in the segmentectomy group. At 3 months after operation, the small airway pulmonary function in the wedge resection group and the anatomic segmentectomy group was better than that was in the 1 month. The pulmonary function in the wedge resection group returned to the preoperative level in the 6 months, and that was also returned in the anatomic segmentectomy group except for the MEF25%.

The small airway pulmonary function indexes could reflect the body′s real lung function. To small pulmonary nodules less than 1 cm and solid components less than 5 mm, the pulmonary function indexes recover faster in the wedge resections′ group than the anatomical segmentectomy′s group. It was suggested that the resected lung tissue was smaller, the preserved lung function was more and the long-term functional advantages were more.