Background:

Three-dimensional (3D) vision systems are available for video-assisted thoracic surgery (VATS). It is unclear whether 3D-VATS is superior to bidimensional (2D) VATS systems.

Methods:

We analyzed patients who received 3D-VATS (n = 171) or 2D-VATS (n = 228) lobectomy in a single institutional retrospective comparative study of 399 patients with resectable lung cancer conducted from June 2012 to December 2017. The operative and perioperative data were compared between the 2 groups.

Results:

Operative time, length of hospital stay, number of dissected lymph nodes, and rate of postoperative complications were similar in both groups. In the 3D group, there was no conversion to thoracotomy for intraoperative major vascular injuries, while conversion to an open procedure for uncontrolled bleeding was recorded in 4 (1.7%) patients in the 2D group. Reoperation for hemostasis and/or aerostasis occurred in 6 (2.6%) patients of the 2D group (p = 0.04).

Conclusion:

Nonrandomized comparison of different surgical approaches is challenging. In our experience, 3D-VATS was safe and effective and offered excellent operative perception and sensitivity, enabling safer dissection of hilar structures. The 3D-VATS system helped skilled surgeons beyond the boundaries of more oncologically aggressive surgery.

中文翻译：

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柔性 3 维和二维视频胸腔镜手术治疗肺癌的临床和肿瘤学疗效比较。

背景：

三维 (3D) 视觉系统可用于电视胸腔镜手术 (VATS)。目前尚不清楚 3D-VATS 是否优于二维 (2D) VATS 系统。

方法：

我们在 2012 年 6 月至 2017 年 12 月对 399 名可切除肺癌患者进行的单一机构回顾性比较研究中分析了接受 3D-VATS ( n = 171) 或 2D-VATS ( n = 228) 肺叶切除术的患者。手术和围手术期数据对2组进行比较。

结果：

两组的手术时间、住院时间、淋巴结清扫数量和术后并发症发生率相似。在 3D 组中，没有因术中大血管损伤而转为开胸手术，而在 2D 组中有 4 名（1.7%）患者因失控出血而转为开胸手术。2D 组 6 例 (2.6%) 患者因止血和/或气滞而再次手术 ( p = 0.04)。

结论：

不同手术方法的非随机比较具有挑战性。根据我们的经验，3D-VATS 安全有效，并提供出色的操作感知和灵敏度，能够更安​​全地解剖肺门结构。3D-VATS 系统帮助熟练的外科医生超越了更具肿瘤侵袭性的手术的界限。