The efficacy of three-dimensional complete VATS lobectomy for lung cancer

Abstract

Currently, complete video-assisted thoracoscopic surgery (VATS) lobectomy using a two-dimensional thoracoscopic (2D) system is performed worldwide. However, one of the disadvantages of the 2D system is the lack of spatial depth, but the three-dimensional thoracoscopic (3D) system, which resolves this problem, has recently been developed. We adopted the 3D system in 2015 for the treatment of patients who had primary lung cancer with tumors ≤30 mm (cN0). In this study, we investigated the efficacy of complete VATS lobectomy using the 3D system (n=34), compared with former consecutive cases of complete VATS lobectomy performed with the 2D system (n=73). The 3D system significantly reduced blood loss (30 vs. 60 g, respectively, p=0.002) and the operative time (202 vs. 224 min, respectively, p=0.029). The adaptation of the 3D system for complete VATS lobectomy might lead to safer surgeries compared with using the 2D system. However, its superiority needs confirmation by larger, prospective, multi-institutional studies, for the widespread adoption of the 3D system.