ObjectiveTo evaluate the clinical efficacy of bovine pericardial patch in reinforcing pulmonary vascular stumps during video-assisted thoracoscopic radical resection for lung cancer, and to analyze its application value and cost-effectiveness based on vascular diameter. MethodsA prospective cohort study was conducted by analyzing clinical data of 200 patients with non-small cell lung cancer who underwent video-assisted thoracic surgery (VATS) lobectomy performed by a single surgeon at Affiliated Hospital of Jining Medical College between May 2024 and May 2025. Patients were divided into an experimental group (reinforced with bovine pericardial patch) and a control group (treated solely with stapler) according to intraoperative management of vascular stumps. Both groups were further stratified into three subgroups based on target vessel diameter: <2 mm, 2-5 mm, and >5 mm. Perioperative outcomes including intraoperative blood loss, postoperative drainage volume (24-hour and total), chest tube duration, hospital stay, operation time, and hospitalization costs were compared between groups. ResultsThe experimental group (n=100) comprised 41 males and 59 females with a median age of 60 (52, 66) years, while the control group (n=100) included 37 males and 63 females with a median age of 61 (53, 68) years. No statistical differences were observed in baseline characteristics between groups (P>0.05). Overall analysis demonstrated that the experimental group exhibited significantly reduced intraoperative blood loss [10 (10, 20) mL vs. 13 (10, 20) mL, P=0.015], shorter chest tube duration [3 (2, 3) days vs. 3 (3, 4) days, P<0.001], hospital stay [7 (6, 8) days vs. 8 (7, 9) days, P<0.001], operation time [56.0 (44.3, 72.8) minutes vs. 74.5 (55.0, 106.5) minutes, P<0.001], and lower total drainage volume [250.0 (172.5, 400.0) mL vs. 400.0 (202.5, 647.5) mL, P=0.001] compared to controls. However, no significant differences were found in 24-hour drainage volume [70 (50, 100) mL vs. 100 (50, 150) mL, P=0.066] or hospitalization costs [32,186.76 (30,098.56, 35,428.41) yuan vs. 33,400.02 (29,704.48, 38,323.72) yuan, P=0.434]. Stratified analysis revealed that the bovine pericardial patch showed superior performance in the 2-5 mm subgroup, where all perioperative parameters and hospitalization costs were significantly improved in the experimental group (P<0.05). Conversely, for vessels measuring <2 mm or >5 mm, the experimental group incurred higher hospitalization costs (P<0.05). ConclusionBovine pericardial patch effectively reduces pulmonary vascular bleeding during VATS lobectomy and accelerates postoperative recovery. Its clinical benefits are most pronounced and economically advantageous when applied to vessels with diameters of 2-5 mm. Selective use of bovine pericardial patch based on vascular diameter can optimize both clinical outcomes and healthcare economic efficiency.
