Three-dimensional versus two-dimensional imaging systems in thoracoscopic lobectomy for lung cancer in different year / 中国医师杂志

Objective To compare the clinical application of three-dimensional (3D) and two-di-mensional (2D) imaging systems in thoracoscopic lobectomy for non-small cell lung cancer ( NSCLC). Methods In 2014 and 2016, the patients with NSCLC undergoing thoracoscopic lobectomy with 2D or 3D imaging systems were performed by a single experienced surgeon. The baseline characteristics and perioper-ative data of the patients were collected and analyzed. Results In 2014, 19 patients underwent 3D thora-coscopic lobectomy and the other 23 patients underwent 2D thoracoscopic lobectomy. Compared to 2D thora-coscopic lobectomy group, 3D thoracoscopic lobectomy group had a significantly shorter operative time [(147.0 ±23.9)min vs (179.1 ±54.4)min,P=0.016], a smaller volume of intraoperative blood loss [(142. 1 ± 69. 3)ml vs (203. 0 ± 90. 4)ml,P=0. 018]. In 2016, 36 patients underwent 3D thoracoscopic lobectomy and the other 32 patients underwent 2D thoracoscopic lobectomy. No significant differences were found between two groups in terms of preoperative indicators. Conclusions To some extent, 3D thoracos-copy reduces the operation difficulty, shortens the operative time and reduces intraoperative blood loss. However, with the accumulation of surgical experience, 2D can effectively compensate for the disadvantages of thoracoscope.

Clinical application of the da vinci robotic system for lung cancer / 中国医师杂志

For early-stage lung cancer,the treatment is given priority to surgery.As a new approach of minimally invasive surgery,three-dimensional and high definition view,and better dexterity robotic platform and tremor filtering system are the main advantages of da vinci robot compared to video-assisted thoracic surgery.In recent years,the technique of robot surgery has become more and more mature and has already been used in the treatment for lung cancer.However,its safety and postoperative outcomes should be evaluated in detailed.As a consequence,the comparison of robotic,video-assisted thoracic surgery and thoracotomy surgery for lung cancer has become a hot spot in recent clinical research.

Thoracoscopic anterior 'fissure first' technique for left lung cancer with an incomplete fissure.

BACKGROUND: Dealing with incomplete lung fissures during thoracoscopic surgery is difficult. Our objective was to evaluate the efficacy and safety of a thoracoscopic anterior 'fissure first' technique for dealing with incomplete left lung fissures. METHODS: One hundred and seventy patients underwent left upper lobectomy or left lower lobectomy between April 2008 and July 2014. Of these, 34 patients underwent surgery using a thoracoscopic anterior 'fissure first' technique for incomplete fissures (group A) and 136 underwent surgery using a conventional thoracoscopic method for unfused fissures (group B). A four-port complete thoracoscopic approach was used in all patients. After completion of the fissure, hilar lymphadenectomy was performed in the conventional manner. RESULTS: There were no significant differences between the two groups in operating time, blood loss, or duration of chest tube drainage. Patients in group A required more staple cartridges than those in group B (mean number of cartridges, 2.4 vs. 1.1; P<0.01). The two groups did not significantly differ with regard to the prevalence of air leaks (12% vs. 4%; P=0.11), either prolonged or delayed. CONCLUSIONS: We found that a thoracoscopic anterior 'fissure first' technique for left lung cancer with an incomplete fissure enabled hilar lymphadenectomy to be performed in the conventional manner without any increase in the prevalence of air leaks, operating time, or duration of chest tube drainage. This technique should be considered for use in left upper lobectomy or left lower lobectomy in patients with an incomplete fissure.