Comparison of three-dimensional and two-dimensional thoracoscopic segmentectomy in lung cancer

Abstract

Thoracoscopic segmentectomy is considered to be a safe and effective procedure for early lung cancer. A three-dimensional (3D) thoracoscope can provide high resolution and accurate images. We compared the outcomes from using two-dimensional (2D) and 3D video systems in thoracoscopic segmentectomy for lung cancer. The data of consecutive patients diagnosed with lung cancer that underwent 2D or 3D thoracoscopic segmentectomy in Changhua Christian Hospital from January 2014 to December 2020 were retrospectively analyzed. Tumor characteristics and perioperative short-term outcomes (operative time, blood loss, incision numbers, length of stay and complication) were compared between 2D and 3D thoracoscopic segmentectomy. Among the 192 patients, 68 patients underwent segmentectomy with a 2D thoracoscopic system and 124 patients had 3D thoracoscopic surgery. Patients undergoing 3D thoracoscopic segmentectomy had a shorter operative time (174.19±64.63min vs. 207.06±72.99min, p=0.002), less blood loss (34.40±43.58ml vs. 50.81±57.61ml, p=0.028), fewer incisions (1.50±0.716 vs. 2.19± .058, p<0.001) and a shorter length of stay (5.67±3.44 days vs. 8.18±11.862 days, p=0.029). The postoperative complications were similar between the two groups. Surgical mortality was not found in any patient. Our finding suggests that the incorporation of a 3D endoscopic system could facilitate thoracoscopic segmentectomy in lung cancer patients.