Comparison of surgical outcomes between 3D and 2D VATS lobectomy for clinical stage I lung cancer

Abstract

Purpose The use of three-dimensional (3D) thoracoscope provides improved depth perception and accuracy in video-assisted thoracoscopic surgery (VATS). This study aimed to compare the surgical outcomes between two-dimensional (2D) and 3D VATS lobectomy for stage I lung cancer. Methods From January 2013 to May 2018, 354 patients underwent VATS lobectomy and mediastinal lymph node dissection for clinical stage I lung cancer. The 3D VATS system was introduced in July 2016 in our center. A total of 182 patients underwent 2D VATS lobectomy from January 2013 to June 2016, and 172 patients underwent 3D VATS lobectomy from July 2016 to May 2018. Results The thoracotomy conversion rate was lower (1.2% vs. 6.4%, P= 0.011) in the 3D VATS group than in the 2D VATS group. Operation time (mean: 119.0 minutes vs. 151.4 minutes, P< 0.001), operative blood loss (median: 100 mL vs. 150 mL, P< 0.001), and length of hospital stay after surgery (median: 5 days vs. 6 days, P< 0.001) were significantly lower in the 3D VATS group than in the 2D VATS group. A higher number of lymph nodes was resected in 3D VATS (mean: 15.9 vs. 13.8, P= 0.006). No significant difference was observed between 3D and 2D VATS in terms of operative complications (Clavien-Dindo classification grade ≥ 1; 14.7% vs. 14.6%, P= 0.322). None of the patients died postoperatively. Conclusion Our retrospective data showed that the 3D thoracoscope had better surgical outcomes than 2D thoracoscope for VATS lobectomy in patients with clinical stage I lung cancer.

Keywords

• lung neoplasms
• thoracic surgery, video-assisted
• three dimensional