不同年度3D与2D胸腔镜肺癌根治术的对比研究

Three-dimensional versus two-dimensional imaging systems in thoracoscopic lobectomy for lung cancer in different year

目的 比较不同年度3D胸腔镜与2D胸腔镜在肺癌根治术中的手术结果.方法 收集本院2014年与2016年同一手术组完成的3D或2D胸腔镜肺癌根治手术,分别比较同一年度两种不同手术方式的围手术期数据.结果 2014年19例患者接受3D胸腔镜手术,23例患者接受2D胸腔镜手术,3D胸腔镜组比2D胸腔组手术时间短[(147.0±23.9)min vs(179.1±54.4)min,P=0.016],术中出血量少[(142.1±69.3)ml vs(203.0±90.4)ml,P=0.018].2016年36例患者接受3D胸腔镜肺癌根治术,32例患者接受2D胸腔镜肺癌根治术,两组间手术时间、术中出血量、术后24 h胸腔引流量及术中淋巴结清扫数比较差异无统计学意义(P>0.05).结论 对于初学者来说,与2 D胸腔镜相对比,3 D胸腔镜在一定程度上可以降低全胸腔肺癌根治术的手术难度,缩短手术时间,减少术中出血量,但是手术者丰富的临床经验可以有效弥补2D胸腔镜的劣势.

Objective To compare the clinical application of three-dimensional (3D) and two-di-mensional (2D) imaging systems in thoracoscopic lobectomy for non-small cell lung cancer ( NSCLC). Methods In 2014 and 2016, the patients with NSCLC undergoing thoracoscopic lobectomy with 2D or 3D imaging systems were performed by a single experienced surgeon. The baseline characteristics and perioper-ative data of the patients were collected and analyzed. Results In 2014, 19 patients underwent 3D thora-coscopic lobectomy and the other 23 patients underwent 2D thoracoscopic lobectomy. Compared to 2D thora-coscopic lobectomy group, 3D thoracoscopic lobectomy group had a significantly shorter operative time [(147.0 ±23.9)min vs (179.1 ±54.4)min,P=0.016], a smaller volume of intraoperative blood loss ((142. 1 ± 69. 3)ml vs (203. 0 ± 90. 4)ml,P=0. 018)In 2016, 36 patients underwent 3D thoracoscopic lobectomy and the other 32 patients underwent 2D thoracoscopic lobectomy. No significant differences were found between two groups in terms of preoperative indicators. Conclusions To some extent, 3D thoracos-copy reduces the operation difficulty, shortens the operative time and reduces intraoperative blood loss. However, with the accumulation of surgical experience, 2D can effectively compensate for the disadvantages of thoracoscope.