Video-assisted Thoracoscopic 3D versus 2D Mode Operation for Solitary Pulmonary Nodules: A Case Control Study_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

GENGGuo-jun , YUXiu-yi ,  JIANGJie , MIYan-jun , SHENGDong-yan , LINing , ZHUJian-wen

Department of Thorocic Surgery, the First Hospital Affiliated to Xiamen University, Xiamen 361003 Fujian, P. R. China;

Corresponding?author：

JIANGJie, Email: jiangjie06@126.com

Keywords：

Thoracoscopy; 3D mode; 2D mode; Operation; Solitary pulmonary nodule

DOI：

10.7507/1007-4848.20150169

Video：

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Objective To compare solitary pulmonary nodule resection via thoracoscopic 3D mode or 2D mode and to further evaluate the clinical application value of thoracoscopic 3D mode. Methods We retrospectively analyzed the clinical data of 120 patients with solitary pulmonary nodule between March 2013 and March 2014 in the First Hospital Affiliated to Xiamen University. The patients were allocated into two groups including a 3D-VATS group (50 patients) and a 2D-VATS group (70 patients). Pulmonary partial resection was performed firstly. Pulmonary lobectomy would be conducted or not on the basis of intra operative rapid pathological results. Results Twenty three patients were performed 3D-VATS in the 3D-VATS group. Twenty-nine patients were diagnosed as pathological malignancy underwent lobectomy plus partial dissection. There were statistical differences between the 3D-VATS group and the 2D-VATS group in operative time (t=1.967, P<0.05), intra operative blood loss (t=7.85, P<0.05), drainage volume 24 h after operation (t=6.18, P<0.05), postoperative chest tube retention time (t=7.1, P<0.05), and postoperative hospital stay (t=2.35, P<0.05). Following-up time in the 3D-VATS group was 6.3 (2-12) months. Complications occurred in 3 patients, including 2 patients with postoperative pneumonia and 1 patient with paroxysmal atrial fibrillation in the 3D-VATS group. The following-up time in the 2D-VATS group was 8.2 (2-15) months. Complications occurred in 4 patients, including 1 patient with chylous hydrothorax, 2 patients with pneumothorax, 1 patient with delayed pulling up the chest closed drainage in the 2D-VATS group. The patients in both groups with complications were cured by appropriate treatment. Conclusion 3D-VAST for SPN is a new operation mode choice. It is safe and feasible with low incidence of postoperative complications. Surgery vision, stereo feeling, the operation of adaptation, and postoperative recovery have certain advantages. It is worthy popularizing.

Citation： GENGGuo-jun, YUXiu-yi, JIANGJie, MIYan-jun, SHENGDong-yan, LINing, ZHUJian-wen. Video-assisted Thoracoscopic 3D versus 2D Mode Operation for Solitary Pulmonary Nodules: A Case Control Study. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(7): 664-667. doi: 10.7507/1007-4848.20150169 Copy

1.	劉明, 姜格寧. 孤立性肺結節的良惡性鑒別及處理策略. 中國胸心血管外科臨床雜志, 2014, 21(1):102-106.
2.	劉倫旭, 車國衛, 蒲強,等. 單向式全胸腔鏡肺葉切除術. 中華胸心血管外科雜志, 2008, 24(3):156-158.
3.	李劍鋒, 李遠, 王俊, 等. 全胸腔鏡下肺葉切除技術要點分析. 中國微創外科雜志, 2009, 9(1):30-32.
4.	何靖康, 唐興, 黃海濤, 等. 電視胸腔鏡肺葉切除術在肺良性疾病中的應用. 中國胸心血管外科臨床雜志, 2013, 20(4):482-483.
5.	Paul S, Ahorki NK, Sheng S, et al. Thoracoscopic lobectomy is associated with lower morbidity than open lobectomy:a propensity matched analysis from the STS database. J Thorac Cardiovasc Surg, 2010,139(2):366-378.
6.	林皓, 黃佳, 羅清泉, 等. 機器人輔助胸腔鏡左肺下葉切除兩例. 中華腔鏡外科雜志:電子版, 2012, 5(4):288-293.
7.	Jeong YJ, Yi GA, Lee KS. Solitary pulmonary nodules:Detection, characterization, and guidance for further diagnostic workup and treatment. Am J Roentgenol, 2007, 188(1):57-68.
8.	劉倫旭, 劉成武. 胸腔鏡肺葉切除方法的探索. 中國胸心血管外科臨床雜志, 2014, 21(4):431-434.
9.	Gould MK, Fletcher J, Iannettoni MD, et al. Evaluation of patients with pulmonary nodules:When is it lung cancer? ACCP evidencebased clinical practice guidelines (2nd edition). Chest, 2007, 132(3):108s-130s.
10.	韓霧, 康明強, 陳椿, 等. 全胸腔鏡單向式肺葉切除術43例報告. 福建醫科大學學報, 2013, 47(3):187-188.
11.	王君, 徐美清. 單中心全胸腔鏡下肺葉切除200例臨床分析. 中國微創外科雜志, 2014, 14(1):19-21.
12.	Gharagozloo F, Margolis M, Tempesta B, et al. Robot-assisted lobectomy for early-stage lung cancer:report of 100 consecutive cases. An n Thorac Surg, 2009, 88(2):380-384.
13.	羅清泉. 機器人外科手術系統在普胸外科中的應用.上海醫學, 2011, 34(1):10-11.
14.	黃佳, 羅清泉, 譚強. 機器入外科手術系統輔助胸腔鏡胸腺瘤切除手術一例. 上海醫學, 2010, 33(11):1072.
15.	王光宇, 初向陽, 李國, 等. 單操作孔電視胸腔鏡與開胸肺癌根治術對早期肺癌淋巴結清掃及療效的對比分析. 中國醫藥, 2014, 9(1):37-40.
16.	吳學志, 朱海文. 胸腔鏡肺葉切除與開胸肺葉切除治療非小細胞肺癌的對比分析. 中國實用醫藥, 2013, 12(34):79-80.
17.	秦偉, 張愛平. 孤立性肺結節的良惡性鑒別診斷進展. 中國胸心血管外科臨床雜志, 2011, 18(2):153-156.
18.	于修義, 姜杰, 耿國軍, 等. 3D電視胸腔鏡肺占位病變切除術. 中國微創外科雜志,2014, 14(4):359-361.
19.	張毅, 李元博, 劉寶東, 等. 全胸腔鏡與胸腔鏡輔助小切口肺葉切除在肺癌手術中的比較. 中華醫學雜志, 2013, 93(37):2972-2975.
20.	伍治強, 李慶新, 萬虹利, 等. 單孔胸腔鏡治療胸部良性病變18例. 中國微創外科雜志, 2014, 14(3):270-272.

1. 劉明, 姜格寧. 孤立性肺結節的良惡性鑒別及處理策略. 中國胸心血管外科臨床雜志, 2014, 21(1):102-106.
2. 劉倫旭, 車國衛, 蒲強,等. 單向式全胸腔鏡肺葉切除術. 中華胸心血管外科雜志, 2008, 24(3):156-158.
3. 李劍鋒, 李遠, 王俊, 等. 全胸腔鏡下肺葉切除技術要點分析. 中國微創外科雜志, 2009, 9(1):30-32.
4. 何靖康, 唐興, 黃海濤, 等. 電視胸腔鏡肺葉切除術在肺良性疾病中的應用. 中國胸心血管外科臨床雜志, 2013, 20(4):482-483.
5. Paul S, Ahorki NK, Sheng S, et al. Thoracoscopic lobectomy is associated with lower morbidity than open lobectomy:a propensity matched analysis from the STS database. J Thorac Cardiovasc Surg, 2010,139(2):366-378.
6. 林皓, 黃佳, 羅清泉, 等. 機器人輔助胸腔鏡左肺下葉切除兩例. 中華腔鏡外科雜志:電子版, 2012, 5(4):288-293.
7. Jeong YJ, Yi GA, Lee KS. Solitary pulmonary nodules:Detection, characterization, and guidance for further diagnostic workup and treatment. Am J Roentgenol, 2007, 188(1):57-68.
8. 劉倫旭, 劉成武. 胸腔鏡肺葉切除方法的探索. 中國胸心血管外科臨床雜志, 2014, 21(4):431-434.
9. Gould MK, Fletcher J, Iannettoni MD, et al. Evaluation of patients with pulmonary nodules:When is it lung cancer? ACCP evidencebased clinical practice guidelines (2nd edition). Chest, 2007, 132(3):108s-130s.
10. 韓霧, 康明強, 陳椿, 等. 全胸腔鏡單向式肺葉切除術43例報告. 福建醫科大學學報, 2013, 47(3):187-188.
11. 王君, 徐美清. 單中心全胸腔鏡下肺葉切除200例臨床分析. 中國微創外科雜志, 2014, 14(1):19-21.
12. Gharagozloo F, Margolis M, Tempesta B, et al. Robot-assisted lobectomy for early-stage lung cancer:report of 100 consecutive cases. An n Thorac Surg, 2009, 88(2):380-384.
13. 羅清泉. 機器人外科手術系統在普胸外科中的應用.上海醫學, 2011, 34(1):10-11.
14. 黃佳, 羅清泉, 譚強. 機器入外科手術系統輔助胸腔鏡胸腺瘤切除手術一例. 上海醫學, 2010, 33(11):1072.
15. 王光宇, 初向陽, 李國, 等. 單操作孔電視胸腔鏡與開胸肺癌根治術對早期肺癌淋巴結清掃及療效的對比分析. 中國醫藥, 2014, 9(1):37-40.
16. 吳學志, 朱海文. 胸腔鏡肺葉切除與開胸肺葉切除治療非小細胞肺癌的對比分析. 中國實用醫藥, 2013, 12(34):79-80.
17. 秦偉, 張愛平. 孤立性肺結節的良惡性鑒別診斷進展. 中國胸心血管外科臨床雜志, 2011, 18(2):153-156.
18. 于修義, 姜杰, 耿國軍, 等. 3D電視胸腔鏡肺占位病變切除術. 中國微創外科雜志,2014, 14(4):359-361.
19. 張毅, 李元博, 劉寶東, 等. 全胸腔鏡與胸腔鏡輔助小切口肺葉切除在肺癌手術中的比較. 中華醫學雜志, 2013, 93(37):2972-2975.
20. 伍治強, 李慶新, 萬虹利, 等. 單孔胸腔鏡治療胸部良性病變18例. 中國微創外科雜志, 2014, 14(3):270-272.

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Video-assisted Thoracoscopic 3D versus 2D Mode Operation for Solitary Pulmonary Nodules: A Case Control Study

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