Wang Yiyang, Wang Zhexin, Yao Feng
Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.
J Thorac Dis. 2020 Dec;12(12):7257-7265. doi: 10.21037/jtd-19-3465.
Video-assisted thoracoscopic surgery (VATS) has been widely used in the lung resections. Reports regarding three-dimension (3D) single-port VATS are very limited. The purpose of this study is to evaluate the perioperative outcomes of 3D single-port VATS in a single medical center.
Totally 523 clinical stage I lung cancer patients underwent surgical resection through VATS operation between September 2016 and October 2017 in our single institution were retrospectively collected and 374 were enrolled. The comparison between 3D single-port VATS and conventional VATS (c-VATS), single-port VATS was conducted focusing on intraoperative and postoperative outcomes. Continuous and categorical variables were analyzed through SPSS software.
The 3D singe-port VATS demonstrated no significant difference neither on the intraoperative outcomes including the operative time and the intraoperative blood loss nor the postoperative outcomes including the length of drainage duration and postoperative complications when against c-VATS and single-port VATS. Besides, 3D singe-port VATS elucidated comparable ability of lymph node dissection with c-VATS in subgroup analysis (P=0.192), both of which were better than single-port VATS group (P<0.001). What's more, the rate of conversion as well as hospital stays of 3D single-port group were also comparable. In subgroup analysis, 3D singe-port VATS also elucidated its safety and feasibility when dealing with routine thoracic surgeries including lobectomy and segmentectomy.
3D single-port VATS, integrating the advantages of single-port VATS and three-dimensional vision of 3D VATS, is a safe and feasible technique and is promising for next-generation thoracoscopic surgery.
电视辅助胸腔镜手术(VATS)已广泛应用于肺切除术。关于三维(3D)单孔VATS的报道非常有限。本研究的目的是评估在单一医疗中心进行3D单孔VATS的围手术期结果。
回顾性收集2016年9月至2017年10月在我们单一机构通过VATS手术进行手术切除的523例临床I期肺癌患者,其中374例被纳入研究。比较3D单孔VATS与传统VATS(c-VATS)、单孔VATS,重点关注术中及术后结果。通过SPSS软件分析连续变量和分类变量。
与c-VATS和单孔VATS相比,3D单孔VATS在术中结果(包括手术时间和术中出血量)和术后结果(包括引流持续时间和术后并发症)方面均无显著差异。此外,在亚组分析中,3D单孔VATS显示出与c-VATS相当的淋巴结清扫能力(P = 0.192),两者均优于单孔VATS组(P < 0.001)。此外,3D单孔组的中转率和住院时间也相当。在亚组分析中,3D单孔VATS在处理包括肺叶切除术和肺段切除术在内的常规胸外科手术时也显示出其安全性和可行性。
3D单孔VATS融合了单孔VATS的优势和3D VATS的三维视野,是一种安全可行的技术,有望用于下一代胸腔镜手术。