Comparative study of three-dimensional versus two-dimensional video-assisted thoracoscopic two-port lobectomy

The advantages and disadvantages of three-dimensional (3D) and two-dimensional (2D) two-port video-assisted thoracoscopic surgery (VATS) lobectomy and systematic dissection of mediastinal lymph nodes for lung cancer were investigated.

Between December 2013 and July 2015 at Beijing Hospital, 191 patients underwent lobectomy and systematic dissection of mediastinal lymph nodes for lung cancer. After applying the study criteria, a total of 165 patients were included and allocated to 3D (n = 76) and 2D (n = 89) groups. Variables of the study design, including duration of surgery, volume of intraoperative bleeding, numbers and groups of lymph nodes dissected, drainage volume after surgery, duration of drainage tube insertion, hospitalization time after surgery, hospitalization costs, and complications, were recorded and analyzed. Intergroup differences for all data were compared and statistically analyzed.

No statistical difference was found between the two groups with respect to duration of surgery, volume of intraoperative bleeding, drainage volume after surgery, duration of drainage tube insertion, hospitalization time after surgery, hospitalization costs, and complications ( P  > 0.05). Additionally, there was no significant difference in the numbers and groups of all lymph nodes or N ₂ lymph nodes resected ( P  > 0.05).

Lobectomy with systematic lymph node dissection can be undertaken with two ports using a 3D thoracoscope, and presents similar results to the use of a traditional 2D thoracoscope, at no greater hospitalization cost but with better operational perception and sensitivity during surgery. Two-port lobectomy with systematic lymph node dissection using a 3D thoracoscope is a safe and effective surgical process for lung cancer treatment.