Glasses-free 3D versus 2D video-assisted thoracoscopic thymectomy: a single-center short-term comparative study

Thymectomy is widely used to for the treatment of thymomas, thymic cysts, thymic adenocarcinomas, and other thymic diseases. The development of video-assisted thoracoscopic surgery (VATS) thymectomy by our team offers the advantages of a glasses-free 3D thoracoscopic system for pulmonary surgery. The aim of the present retrospective study was to compare the advantages and short-term outcomes of glasses-free 3D VATS vs. 2D VATS for the treatment of thymic diseases.

The medical records of patients who underwent traditional 2D and glasses-free 3D video-assisted thoracoscopic thymectomy at the First Affiliated Hospital of Guangzhou Medical University from May 2015 to December 2018 were retrospectively reviewed, while focusing on the collection, evaluation, and comparison of clinical data and perioperative manifestations.

A total of 152 patients were included, of which 71 patients underwent glasses-free 3D VATS and 81 underwent 2D VATS. There were no significant differences in demographic characteristics and baseline variables between the two groups (P>0.05). The overall surgical duration was significantly shorter in the 3D group than the 2D group (105.08±4.08 vs. 119.93±4.81 min, respectively, P=0.022). Further intergroup comparisons revealed that the median estimated intraoperative blood loss volume (10 vs. 20 mL, respectively, P=0.038) was less, postoperative thoracic tube indwelling rate (43/71 vs. 64/81, respectively, P=0.013) was lower, and the median duration of postoperative hospitalization (3 vs. 4 days, respectively, P=0.034) was shorter in the 3D group than the 2D group. Although no patient had died, complications occurred in 5 (7.0%) patients in the 3D group and 9 (11.1%) in the 2D group (P=0.387).

As compared with traditional 2D thoracoscopy, glasses-free 3D VATS thymectomy is both safe and effective, and can shorten the surgical duration, reduce blood loss, decrease the indwelling rate of thoracic tube, and shorten the postoperative length of hospitalization.