Department of Gastroenterological Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
Esophagus. 2019 Jul;16(3):272-277. doi: 10.1007/s10388-019-00661-4. Epub 2019 Mar 19.
The three-dimensional video-assisted (3D-VA) system is known to provide depth perception and the precise measurement of anatomical spaces, unlike the two-dimensional video-assisted (2D-VA) system. However, the advantages of the 3D-VA system in thoracoscopic esophagectomy remains unclear.
We retrospectively analyzed data from 104 patients who underwent thoracoscopic esophagectomy for esophageal cancer from 2016 to 2017. We performed thoracic esophagectomy using either the 2D-VA or 3D-VA system during this period. Whenever the 3D-VA system was available in our surgical center, we performed 3D-VA thoracoscopic esophagectomy. Perioperative parameters, including operation times, blood loss, the number of dissected lymph nodes, postoperative complications, and the duration of postoperative hospital stays, were compared between the 2D-VA and 3D-VA system groups.
There were 51 and 53 patients in the 2D-VA and 3D-VA system groups, respectively. Preoperative parameters, including age, sex, tumor location, clinical stage and the distribution of preoperative treatment, were not significantly different between the groups. Although intraoperative blood loss did not differ between the two groups, operation times were significantly shorter in the 3D-VA system group than the 2D-VA system group (P = 0.023). The number of dissected mediastinal lymph nodes was similar in both groups. The incidences of postoperative complications, including pneumonia, recurrent nerve palsy, anastomotic leakages and chylothorax, were similar between the groups. The duration of postoperative hospital stays was also comparable between the groups.
An introduction of 3D-VA endoscopy into minimally invasive esophagectomies may contribute to the shortening of the duration of thoracoscopic procedures.
与二维视频辅助（2D-VA）系统不同，三维视频辅助（3D-VA）系统能够提供深度感知和对解剖空间的精确测量。然而，3D-VA 系统在胸腔镜食管切除术方面的优势尚不清楚。
我们回顾性分析了 2016 年至 2017 年间接受胸腔镜食管癌切除术的 104 例患者的数据。在此期间，我们使用 2D-VA 或 3D-VA 系统进行了胸段食管切除术。只要我们的手术中心配备了 3D-VA 系统，我们就会进行 3D-VA 胸腔镜食管切除术。比较了 2D-VA 和 3D-VA 系统组之间的围手术期参数，包括手术时间、出血量、解剖淋巴结数量、术后并发症以及术后住院时间。
2D-VA 和 3D-VA 系统组分别有 51 例和 53 例患者。两组患者的术前参数，包括年龄、性别、肿瘤部位、临床分期和术前治疗分布，均无显著差异。虽然两组术中出血量无差异，但 3D-VA 系统组的手术时间明显短于 2D-VA 系统组（P=0.023）。两组纵隔淋巴结清扫数量相似。两组术后并发症发生率，包括肺炎、喉返神经麻痹、吻合口漏和乳糜胸，相似。两组术后住院时间也相当。
将 3D-VA 内镜引入微创食管切除术可能有助于缩短胸腔镜手术的持续时间。
