Complete thoracoscopic lobectomy for cancer: comparative study of three-dimensional high-definition with two-dimensional high-definition video systems †.
OBJECTIVE
Common video systems for video-assisted thoracic surgery (VATS) provide the surgeon a two-dimensional (2D) image. This study aimed to evaluate performances of a new three-dimensional high definition (3D-HD) system in comparison with a two-dimensional high definition (2D-HD) system when conducting a complete thoracoscopic lobectomy (CTL).


METHODS
This multi-institutional comparative study trialled two video systems: 2D-HD and 3D-HD video systems used to conduct the same type of CTL. The inclusion criteria were T1N0M0 non-small-cell lung carcinoma (NSCLC) in the left lower lobe and suitable for thoracoscopic resection. The CTL was performed by the same surgeon using either a 3D-HD or 2D-HD system. Eighteen patients with NSCLC were included in the study between January and December 2013: 14 males, 4 females, with a median age of 65.6 years (range: 49-81). The patients were randomized before inclusion into two groups: to undergo surgery with the use of a 2D-HD or 3D-HD system. We compared operating time, the drainage duration, hospital stay and the N upstaging rate from the definitive histology.


RESULTS
The use of the 3D-HD system significantly reduced the surgical time (by 17%). However, chest-tube drainage, hospital stay, the number of lymph-node stations and upstaging were similar in both groups.


CONCLUSIONS
The main finding was that 3D-HD system significantly reduced the surgical time needed to complete the lobectomy. Thus, future integration of 3D-HD systems should improve thoracoscopic surgery, and enable more complex resections to be performed. It will also help advance the field of endoscopically assisted surgery.
Department of Thoracic and Vascular Surgery, Victor Dupouy Hospital, Argenteuil, France Department of Thoracic Surgery, Amiens Picardie University Hospital, Amiens, France Department of Thoracic Surgery and Lung Transplantation, Pompidou European Hospital, Paris V University, Paris, France patrick.bagan@ch-argenteuil.fr.
Patrick
P
Bagan
Department of Thoracic Surgery, Amiens Picardie University Hospital, Amiens, France.
Florence
F
De Dominicis
Department of Thoracic and Vascular Surgery, Victor Dupouy Hospital, Argenteuil, France.
Jacques
J
Hernigou
Department of Thoracic and Vascular Surgery, Victor Dupouy Hospital, Argenteuil, France.
Bassel
B
Dakhil
Department of Thoracic and Vascular Surgery, Victor Dupouy Hospital, Argenteuil, France.
Rym
R
Zaimi
Department of Thoracic Surgery and Lung Transplantation, Pompidou European Hospital, Paris V University, Paris, France.
Ciprian
C
Pricopi
Department of Thoracic Surgery and Lung Transplantation, Pompidou European Hospital, Paris V University, Paris, France.
Françoise
F
Le Pimpec Barthes
Department of Thoracic Surgery, Amiens Picardie University Hospital, Amiens, France.
Pascal
P
Berna
D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000601:surgery*; D015505:Chest Tubes; D002983:Clinical Competence; D004322:Drainage / Q000295:instrumentation; D004867:Equipment Design; D005260:Female; D005602:France; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D059032:Learning Curve; D007902:Length of Stay; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D061646:Operative Time; D011013:Pneumonectomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D011446:Prospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D020708:Thoracoscopes; D013997:Time Factors; D016896:Treatment Outcome
Lung cancer; Three-dimensional video system; Video-assisted thoracic surgery lobectomy