Clinical study of 3D versus 2D thoracoscopic surgeries in uniportal lobectomy_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

HUANG Kenan , DING Xinyu , CHEN Zihao , WEI Rongqiang , CHEN Yu , XU Zhifei ,  TANG Hua

Department of Minimally Invasive Thoracic Surgery Center, Changzheng Hospital, Second Military Medical University, Shanghai, 200003, P.R.China;

Corresponding author：

TANG Hua, Email: tanghua999@smmu.edu.cn

Keywords：

3D thoracoscopy; lung cancer; lobectomy; treatment

DOI：

10.7507/1672-2531.201910044

Video：

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ObjectiveTo investigate the safety and efficacy of 3D thoracoscopic surgery in uniportal lobectomy.MethodsClinical data of 248 patients with lung cancer who underwent uniportal thoracoscopic lobectomy in our hospital from September 2018 to May 2019 were retrospectively analyzed. Patients were divided into two groups according to different surgical methods, a 3D thoracoscopic group (76 patients, including 52 males and 24 females with an average age of 58.59±7.62 years) and a 2D thoracoscopic group (172 patients, including 102 males and 70 females with an average age of 57.75±8.59 years). Statistical analysis of clinical and pathological data, lymph node dissection, surgical complications, postoperative hospital stay, etc was performed.ResultsCompared with the 2D thoracoscopic group, the 3D thoracoscopic group had shorter operation time, more lymph nodes dissected and pleural effusion on the first day after operation (P<0.05). There was no significant difference in the postoperative chest tube duration, postoperative hospital stay, incidence of pulmonary infection, arrhythmia, bronchopleural fistula, or recurrent laryngeal nerve injury between the two groups.ConclusionCompared with the traditional 2D thoracoscopic minimally invasive surgery, uniportal lobectomy with 3D thoracoscopic surgery is safer and more efficient during operation, and lymph node dissection is more thorough, which is worth promoting.

Citation： HUANG Kenan, DING Xinyu, CHEN Zihao, WEI Rongqiang, CHEN Yu, XU Zhifei, TANG Hua. Clinical study of 3D versus 2D thoracoscopic surgeries in uniportal lobectomy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(7): 770-774. doi: 10.7507/1672-2531.201910044 Copy

1.	Oda R, Okuda K, Osaga S, et al. Long-term outcomes of video-assisted thoracoscopic surgery lobectomy vs. thoracotomy lobectomy for stage ⅠA non-small cell lung cancer. Surg Today, 2019, 49(5): 369-377.
2.	Wang BY, Liu CY, Hsu PK, et al. Single-incision versus multiple-incision thoracoscopic lobectomy and segmentectomy: a propensity-matched analysis. Ann Surg, 2015, 261(4): 793-799.
3.	Gonzalez-Rivas D, Paradela M, Fieira E, et al. Single-incision video-assisted thoracoscopic lobectomy: initial results. J Thorac Cardiovasc Surg, 2012, 143(3): 745-747.
4.	Gonzalez-Rivas D, Paradela M, Fernandez R, et al. Uniportal video-assisted thoracoscopic lobectomy: two years of experience. Ann Thorac Surg, 2013, 95(4): 426-432.
5.	Abah U, Casali G, Batchelor TJP, et al. Pathological lymph node involvement is not a predictor of adverse outcomes in patients undergoing thoracoscopic lobectomy for lung cancer? Eur J Cardiothorac Surg, 2018, 53(2): 342-347.
6.	Ettinger DS, Wood DE, Aisner DL, et al. Non-small cell lung cancer, Version 5. 2017, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw, 2017, 15(3): 504-535.
7.	Detterbeck FC, Lewis SZ, Diekemper R, et al. Executive summary: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 2013, 143(5 Suppl): 7S-37S.
8.	Postmus PE, Kerr KM, Oudkerk M, et al. Early and locally advanced nonsmall-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol, 2017, 28(3): 1-21.
9.	Pagès PB, Delpy JP, Orsini B, et al. Propensity score analysis comparing videothoracoscopic lobectomy with thoracotomy: A French nationwide study. Ann Thorac Surg, 2016, 101(4): 1370-1378.
10.	Yang CJ, Kumar A, Klapper JA, et al. A national analysis of long-term survival following thoracoscopic vs open lobectomy for stage Ⅰ non-small cell lung cancer. Ann Surg, 2019, 269(3): 163-171.
11.	Laursen LØ, Petersen RH, Hansen HJ, et al. Video-assisted thoracoscopic surgery lobectomy for lung cancer is associated with a lower 30-day morbidity compared with lobectomy by thoracotomy. Eur J Cardiothorac Surg, 2016, 49(3): 870-875.
12.	Yang CF, Sun Z, Speicher PJ, et al. Use and outcomes of minimally invasive lobectomy for stage Ⅰ non-small cell lung cancer in the National Cancer Data Base. Ann Thorac Surg, 2016, 101(3): 1037-1042.
13.	Hartwig MG, D'Amico TA. Thoracoscopic lobectomy: the gold standard for early-stage lung cancer? Ann Thorac Surg, 2010, 89(6): S2098-S2101.
14.	Rocco G. Towards a standardized approach for video-assisted thoracoscopic surgery lobectomy. Eur J Cardiothorac Surg, 2014, 46(1): 106.
15.	McElnay P, Casali G, Batchelor T, et al. Adopting a standardized anterior approach significantly increases video-assisted thoracoscopic surgery lobectomy rates. Eur J Cardiothorac Surg, 2014, 46(1): 100-105.
16.	Decaluwé H, Stanzi A, Dooms C, et al. Central tumour location should be considered when comparing N1 upstaging between thoracoscopic and open surgery for clinical stage Ⅰ non-small-cell lung cancer. Eur J Cardiothorac Surg, 2016, 50(1): 110-117.
17.	Nakamura H, Sakai H, Kimura H, et al. Chronological changes in lung cancer surgery in a single Japanese institution. Onco Targets Ther, 2017, 10: 1459-1464.
18.	Aokage K, Miyoshi T, Ishii G, et al. Influence of ground glass opacity and the corresponding pathological findings on survival in patients with clinical stage Ⅰ non-small cell lung cancer. J Thorac Oncol, 2018, 13(4): 533-542.
19.	Yang J, Xia Y, Yang Y, et al. Risk factors for major adverse events of video-assisted thoracic surgery lobectomy for lung cancer. Int J Med Sci, 2014, 11(9): 863-869.
20.	Asamura H, Chansky K, Crowley J, et al. The International Association for the Study of Lung Cancer lung cancer staging project: proposals for the revision of the N descriptors in the forthcoming 8th edition of the TNM classification for lung cancer. J Thorac Oncol, 2015, 10(12): 1675-1684.
21.	Irie M, Nakanishi R, Yasuda M, et al. Risk factors for short-term outcomes after thoracoscopic lobectomy for lung cancer. Eur Respir J, 2016, 48(2): 495-503.

1. Oda R, Okuda K, Osaga S, et al. Long-term outcomes of video-assisted thoracoscopic surgery lobectomy vs. thoracotomy lobectomy for stage ⅠA non-small cell lung cancer. Surg Today, 2019, 49(5): 369-377.
2. Wang BY, Liu CY, Hsu PK, et al. Single-incision versus multiple-incision thoracoscopic lobectomy and segmentectomy: a propensity-matched analysis. Ann Surg, 2015, 261(4): 793-799.
3. Gonzalez-Rivas D, Paradela M, Fieira E, et al. Single-incision video-assisted thoracoscopic lobectomy: initial results. J Thorac Cardiovasc Surg, 2012, 143(3): 745-747.
4. Gonzalez-Rivas D, Paradela M, Fernandez R, et al. Uniportal video-assisted thoracoscopic lobectomy: two years of experience. Ann Thorac Surg, 2013, 95(4): 426-432.
5. Abah U, Casali G, Batchelor TJP, et al. Pathological lymph node involvement is not a predictor of adverse outcomes in patients undergoing thoracoscopic lobectomy for lung cancer? Eur J Cardiothorac Surg, 2018, 53(2): 342-347.
6. Ettinger DS, Wood DE, Aisner DL, et al. Non-small cell lung cancer, Version 5. 2017, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw, 2017, 15(3): 504-535.
7. Detterbeck FC, Lewis SZ, Diekemper R, et al. Executive summary: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 2013, 143(5 Suppl): 7S-37S.
8. Postmus PE, Kerr KM, Oudkerk M, et al. Early and locally advanced nonsmall-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol, 2017, 28(3): 1-21.
9. Pagès PB, Delpy JP, Orsini B, et al. Propensity score analysis comparing videothoracoscopic lobectomy with thoracotomy: A French nationwide study. Ann Thorac Surg, 2016, 101(4): 1370-1378.
10. Yang CJ, Kumar A, Klapper JA, et al. A national analysis of long-term survival following thoracoscopic vs open lobectomy for stage Ⅰ non-small cell lung cancer. Ann Surg, 2019, 269(3): 163-171.
11. Laursen LØ, Petersen RH, Hansen HJ, et al. Video-assisted thoracoscopic surgery lobectomy for lung cancer is associated with a lower 30-day morbidity compared with lobectomy by thoracotomy. Eur J Cardiothorac Surg, 2016, 49(3): 870-875.
12. Yang CF, Sun Z, Speicher PJ, et al. Use and outcomes of minimally invasive lobectomy for stage Ⅰ non-small cell lung cancer in the National Cancer Data Base. Ann Thorac Surg, 2016, 101(3): 1037-1042.
13. Hartwig MG, D'Amico TA. Thoracoscopic lobectomy: the gold standard for early-stage lung cancer? Ann Thorac Surg, 2010, 89(6): S2098-S2101.
14. Rocco G. Towards a standardized approach for video-assisted thoracoscopic surgery lobectomy. Eur J Cardiothorac Surg, 2014, 46(1): 106.
15. McElnay P, Casali G, Batchelor T, et al. Adopting a standardized anterior approach significantly increases video-assisted thoracoscopic surgery lobectomy rates. Eur J Cardiothorac Surg, 2014, 46(1): 100-105.
16. Decaluwé H, Stanzi A, Dooms C, et al. Central tumour location should be considered when comparing N1 upstaging between thoracoscopic and open surgery for clinical stage Ⅰ non-small-cell lung cancer. Eur J Cardiothorac Surg, 2016, 50(1): 110-117.
17. Nakamura H, Sakai H, Kimura H, et al. Chronological changes in lung cancer surgery in a single Japanese institution. Onco Targets Ther, 2017, 10: 1459-1464.
18. Aokage K, Miyoshi T, Ishii G, et al. Influence of ground glass opacity and the corresponding pathological findings on survival in patients with clinical stage Ⅰ non-small cell lung cancer. J Thorac Oncol, 2018, 13(4): 533-542.
19. Yang J, Xia Y, Yang Y, et al. Risk factors for major adverse events of video-assisted thoracic surgery lobectomy for lung cancer. Int J Med Sci, 2014, 11(9): 863-869.
20. Asamura H, Chansky K, Crowley J, et al. The International Association for the Study of Lung Cancer lung cancer staging project: proposals for the revision of the N descriptors in the forthcoming 8th edition of the TNM classification for lung cancer. J Thorac Oncol, 2015, 10(12): 1675-1684.
21. Irie M, Nakanishi R, Yasuda M, et al. Risk factors for short-term outcomes after thoracoscopic lobectomy for lung cancer. Eur Respir J, 2016, 48(2): 495-503.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical study of 3D versus 2D thoracoscopic surgeries in uniportal lobectomy

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