免散瞳3D与2D电视辅助胸腔镜胸腺切除术：一项单中心短期比较研究。
Glasses-free 3D versus 2D video-assisted thoracoscopic thymectomy: a single-center short-term comparative study.
作者信息
Li Xukai, Cui Fei, Xing Tuo, Huang Ying, Deng Jinghui, Hao Zhexue, Liu Jun, He Jianxing
机构信息
Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China.
Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou 511436, China.
出版信息
Ann Transl Med. 2019 Dec;7(23):761. doi: 10.21037/atm.2019.11.96.
BACKGROUND
Thymectomy is widely used to for the treatment of thymomas, thymic cysts, thymic adenocarcinomas, and other thymic diseases. The development of video-assisted thoracoscopic surgery (VATS) thymectomy by our team offers the advantages of a glasses-free 3D thoracoscopic system for pulmonary surgery. The aim of the present retrospective study was to compare the advantages and short-term outcomes of glasses-free 3D VATS . 2D VATS for the treatment of thymic diseases.
METHODS
The medical records of patients who underwent traditional 2D and glasses-free 3D video-assisted thoracoscopic thymectomy at the First Affiliated Hospital of Guangzhou Medical University from May 2015 to December 2018 were retrospectively reviewed, while focusing on the collection, evaluation, and comparison of clinical data and perioperative manifestations.
RESULTS
A total of 152 patients were included, of which 71 patients underwent glasses-free 3D VATS and 81 underwent 2D VATS. There were no significant differences in demographic characteristics and baseline variables between the two groups (P>0.05). The overall surgical duration was significantly shorter in the 3D group than the 2D group (105.08±4.08 . 119.93±4.81 min, respectively, P=0.022). Further intergroup comparisons revealed that the median estimated intraoperative blood loss volume (10 . 20 mL, respectively, P=0.038) was less, postoperative thoracic tube indwelling rate (43/71 . 64/81, respectively, P=0.013) was lower, and the median duration of postoperative hospitalization (3 . 4 days, respectively, P=0.034) was shorter in the 3D group than the 2D group. Although no patient had died, complications occurred in 5 (7.0%) patients in the 3D group and 9 (11.1%) in the 2D group (P=0.387).
CONCLUSIONS
As compared with traditional 2D thoracoscopy, glasses-free 3D VATS thymectomy is both safe and effective, and can shorten the surgical duration, reduce blood loss, decrease the indwelling rate of thoracic tube, and shorten the postoperative length of hospitalization.
背景
胸腺切除术广泛应用于胸腺瘤、胸腺囊肿、胸腺腺癌及其他胸腺疾病的治疗。我们团队研发的电视辅助胸腔镜手术（VATS）胸腺切除术具有无眼镜3D胸腔镜系统用于肺部手术的优势。本回顾性研究的目的是比较无眼镜3D VATS与2D VATS治疗胸腺疾病的优势及短期疗效。
方法
回顾性分析2015年5月至2018年12月在广州医科大学附属第一医院接受传统2D和无眼镜3D电视辅助胸腔镜胸腺切除术患者的病历，重点收集、评估和比较临床资料及围手术期表现。
结果
共纳入152例患者，其中71例行无眼镜3D VATS，81例行2D VATS。两组患者的人口统计学特征和基线变量无显著差异（P>0.05）。3D组的总体手术时间明显短于2D组（分别为105.08±4.08和119.93±4.81分钟，P=0.022）。进一步的组间比较显示，3D组的术中估计失血量中位数（分别为10和20 mL，P=0.038）更少，术后胸管留置率（分别为43/71和64/81，P=0.013）更低，术后住院时间中位数（分别为3和4天，P=0.034）更短。虽然无患者死亡，但3D组有5例（7.0%）患者发生并发症，2D组有9例（11.1%）患者发生并发症（P=0.387）。
结论
与传统2D胸腔镜相比，无眼镜3D VATS胸腺切除术安全有效，可缩短手术时间，减少失血量，降低胸管留置率，缩短术后住院时间。
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