肺癌三维与二维胸腔镜肺段切除术的比较
Comparison of three-dimensional and two-dimensional thoracoscopic segmentectomy in lung cancer.
作者信息
Shen Ming-Sheng, Hsieh Ming-Yu, Lin Ching-Hsiung, Wang Bing-Yen
机构信息
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Taichung Armed-Forces General Hospital, Taichung, Taiwan.
Department of Otorhinolaryngology-Head and Neck Surgery, Changhua Christian Hospital, Changhua, Taiwan; Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taiwan.
出版信息
Asian J Surg. 2023 Jul;46(7):2657-2661. doi: 10.1016/j.asjsur.2022.09.154. Epub 2022 Oct 29.
BACKGROUND
Thoracoscopic segmentectomy is considered to be a safe and effective procedure for early lung cancer. A three-dimensional (3D) thoracoscope can provide high resolution and accurate images. We compared the outcomes from using two-dimensional (2D) and 3D video systems in thoracoscopic segmentectomy for lung cancer.
METHODS
The data of consecutive patients diagnosed with lung cancer that underwent 2D or 3D thoracoscopic segmentectomy in Changhua Christian Hospital from January 2014 to December 2020 were retrospectively analyzed. Tumor characteristics and perioperative short-term outcomes (operative time, blood loss, incision numbers, length of stay and complication) were compared between 2D and 3D thoracoscopic segmentectomy.
RESULTS
Among the 192 patients, 68 patients underwent segmentectomy with a 2D thoracoscopic system and 124 patients had 3D thoracoscopic surgery. Patients undergoing 3D thoracoscopic segmentectomy had a shorter operative time (174.19 ± 64.63 min vs. 207.06 ± 72.99 min, p = 0.002), less blood loss (34.40 ± 43.58 ml vs. 50.81 ± 57.61 ml, p = 0.028), fewer incisions (1.50 ± 0.716 vs. 2.19 ± .058, p < 0.001) and a shorter length of stay (5.67 ± 3.44 days vs. 8.18 ± 11.862 days, p = 0.029). The postoperative complications were similar between the two groups. Surgical mortality was not found in any patient.
CONCLUSION
Our finding suggests that the incorporation of a 3D endoscopic system could facilitate thoracoscopic segmentectomy in lung cancer patients.
背景
胸腔镜肺段切除术被认为是治疗早期肺癌的一种安全有效的手术方法。三维（3D）胸腔镜能够提供高分辨率和精确的图像。我们比较了二维（2D）和三维视频系统在肺癌胸腔镜肺段切除术中的应用效果。
方法
回顾性分析2014年1月至2020年12月在彰化基督教医院接受二维或三维胸腔镜肺段切除术的连续肺癌患者的数据。比较二维和三维胸腔镜肺段切除术的肿瘤特征和围手术期短期结局（手术时间、失血量、切口数量、住院时间和并发症）。
结果
192例患者中，68例采用二维胸腔镜系统进行肺段切除术，124例接受三维胸腔镜手术。接受三维胸腔镜肺段切除术的患者手术时间较短（174.19±64.63分钟对207.06±72.99分钟，p = 0.002），失血量较少（34.40±43.58毫升对50.81±57.61毫升，p = 0.028），切口较少（1.50±0.716对2.19±0.58，p < 0.001），住院时间较短（5.67±3.44天对8.18±11.862天，p = 0.029）。两组术后并发症相似。未发现任何患者手术死亡。
结论
我们的研究结果表明，采用三维内镜系统有助于肺癌患者的胸腔镜肺段切除术。
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