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.	刘明, 姜格宁. 孤立性肺结节的良恶性鉴别及处理策略. 中国胸心血管外科临床杂志, 2014, 21(1):102-106.
2.	刘伦旭, 车国卫, 蒲强,等. 单向式全胸腔镜肺叶切除术. 中华胸心血管外科杂志, 2008, 24(3):156-158.
3.	李剑锋, 李远, 王俊, 等. 全胸腔镜下肺叶切除技术要点分析. 中国微创外科杂志, 2009, 9(1):30-32.
4.	何靖康, 唐兴, 黄海涛, 等. 电视胸腔镜肺叶切除术在肺良性疾病中的应用. 中国胸心血管外科临床杂志, 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, 黄佳, 罗清泉, 等. 机器人辅助胸腔镜左肺下叶切除两例. 中华腔镜外科杂志:电子版, 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.	刘伦旭, 刘成武. 胸腔镜肺叶切除方法的探索. 中国胸心血管外科临床杂志, 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.
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11.	王君, 徐美清. 单中心全胸腔镜下肺叶切除200例临床分析. 中国微创外科杂志, 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.	罗清泉. 机器人外科手术系统在普胸外科中的应用.上海医学, 2011, 34(1):10-11.
14.	黄佳, 罗清泉, 谭强. 机器入外科手术系统辅助胸腔镜胸腺瘤切除手术一例. 上海医学, 2010, 33(11):1072.
15.	王光宇, 初向阳, 李国, 等. 单操作孔电视胸腔镜与开胸肺癌根治术对早期肺癌淋巴结清扫及疗效的对比分析. 中国医药, 2014, 9(1):37-40.
16.	吴学志, 朱海文. 胸腔镜肺叶切除与开胸肺叶切除治疗非小细胞肺癌的对比分析. 中国实用医药, 2013, 12(34):79-80.
17.	秦伟, 张爱平. 孤立性肺结节的良恶性鉴别诊断进展. 中国胸心血管外科临床杂志, 2011, 18(2):153-156.
18.	于修义, 姜杰, 耿国军, 等. 3D电视胸腔镜肺占位病变切除术. 中国微创外科杂志,2014, 14(4):359-361.
19.	张毅, 李元博, 刘宝东, 等. 全胸腔镜与胸腔镜辅助小切口肺叶切除在肺癌手术中的比较. 中华医学杂志, 2013, 93(37):2972-2975.
20.	伍治强, 李庆新, 万虹利, 等. 单孔胸腔镜治疗胸部良性病变18例. 中国微创外科杂志, 2014, 14(3):270-272.

1. 刘明, 姜格宁. 孤立性肺结节的良恶性鉴别及处理策略. 中国胸心血管外科临床杂志, 2014, 21(1):102-106.
2. 刘伦旭, 车国卫, 蒲强,等. 单向式全胸腔镜肺叶切除术. 中华胸心血管外科杂志, 2008, 24(3):156-158.
3. 李剑锋, 李远, 王俊, 等. 全胸腔镜下肺叶切除技术要点分析. 中国微创外科杂志, 2009, 9(1):30-32.
4. 何靖康, 唐兴, 黄海涛, 等. 电视胸腔镜肺叶切除术在肺良性疾病中的应用. 中国胸心血管外科临床杂志, 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, 黄佳, 罗清泉, 等. 机器人辅助胸腔镜左肺下叶切除两例. 中华腔镜外科杂志:电子版, 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. 刘伦旭, 刘成武. 胸腔镜肺叶切除方法的探索. 中国胸心血管外科临床杂志, 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. 韩雾, 康明强, 陈椿, 等. 全胸腔镜单向式肺叶切除术43例报告. 福建医科大学学报, 2013, 47(3):187-188.
11. 王君, 徐美清. 单中心全胸腔镜下肺叶切除200例临床分析. 中国微创外科杂志, 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. 罗清泉. 机器人外科手术系统在普胸外科中的应用.上海医学, 2011, 34(1):10-11.
14. 黄佳, 罗清泉, 谭强. 机器入外科手术系统辅助胸腔镜胸腺瘤切除手术一例. 上海医学, 2010, 33(11):1072.
15. 王光宇, 初向阳, 李国, 等. 单操作孔电视胸腔镜与开胸肺癌根治术对早期肺癌淋巴结清扫及疗效的对比分析. 中国医药, 2014, 9(1):37-40.
16. 吴学志, 朱海文. 胸腔镜肺叶切除与开胸肺叶切除治疗非小细胞肺癌的对比分析. 中国实用医药, 2013, 12(34):79-80.
17. 秦伟, 张爱平. 孤立性肺结节的良恶性鉴别诊断进展. 中国胸心血管外科临床杂志, 2011, 18(2):153-156.
18. 于修义, 姜杰, 耿国军, 等. 3D电视胸腔镜肺占位病变切除术. 中国微创外科杂志,2014, 14(4):359-361.
19. 张毅, 李元博, 刘宝东, 等. 全胸腔镜与胸腔镜辅助小切口肺叶切除在肺癌手术中的比较. 中华医学杂志, 2013, 93(37):2972-2975.
20. 伍治强, 李庆新, 万虹利, 等. 单孔胸腔镜治疗胸部良性病变18例. 中国微创外科杂志, 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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