Abstract：【Objective】 To to explore the effect of 3D and 2D thoracoscopic radical resection on perioperative immune function of patients with lung cancer. 【Methods】 The clinical data of 59 patients with lung cancer who underwent thoracoscopic radical resection of lung cancer in Suqian Hospital of Nanjing Drum Tower Hospital Group and the Nanjing Gulou Hospital from March 2019 to March 2022 were retrospectively analyzed. According to the different surgical methods, they were divided into observation group (n=30) and control group (n=29). Patients in the observation group underwent radical lung cancer surgery with 3D video-assisted thoracoscopy system, while patients in the control group underwent radical lung cancer surgery with 2D video-assisted thoracoscopy system. The perioperative operation time, intraoperative bleeding volume, number of lymph node dissections, retention time of drainage tube and hospitalization time were compared between the two groups. The levels of carcinoembryonic antigen (CEA), carbohydrate antigen 50 (CA50), cytokeratin 19 fragment antigen 21-1(CYFRA21-1) and T lymphocyte subsets CD4+, CD8+, CD4+/CD8+ before and after operation were compared between the two groups. The postoperative complications of the two groups were compared. 【Results】 The operation time, intraoperative bleeding volume, retention time of drainage tube and hospitalization time of the observation group were shorter than those of the control group, and the number of lymph node dissection was greater than that of the control group (P<0.05). There was no significant difference in CEA, CA50 and CYFRA21-1 between the two groups before and after operation (P>0.05); The levels of CEA, CA50 and CYFRA21-1 in both groups were significantly lower than those before operation (P<0.05). CD4+, CD8+, CD4+/CD8+ in both groups were significantly better than that before operation, and the observation group was significantly better than the control group (P<0.05). The total incidence of postoperative complications in the observation group was 13.33% (4/30), which was lower than that in the control group [20.69%(6/29)], but the difference was not statistically significant (P>0.05). 【Conclusion】Radical resection of lung cancer under 3D and 2D thoracoscopy has no significant effect on tumor marker level and complication rate of patients, but 3D thoracoscopy can shorten the operation time, drainage tube retention time, hospital stay, reduce intraoperative bleeding, and have little impact on the immune function of patients.
李威, 周勇, 游锦智, 顾鑫童. 3D及2D胸腔镜模式下肺癌根治术对肺癌患者围术期免疫功能的影响[J]. 医学临床研究, 2022, 39(8): 1186-1189.
LI Wei, ZHOU Yong, YOU Jin-zhi, et al. Effect of 3D and 2D Thoracoscopic Radical Resection of Lung Cancer on Perioperative Immune Function of Patients with Lung Cancer. JOURNAL OF CLINICAL RESEARCH, 2022, 39(8): 1186-1189.
[1] ENGELHARDT K E,ODELL D D,DECAMP M M. Optimal local therapy for early-stage small cell lung cancer:Surgery needs a seat at the table[J].Translat Cancer Res,2017,6(7):1248-1252. [2] HARUKI T,YURUGI Y,WAKAHARA M,et al. Simplified comorbidity score for elderly patients undergoing thoracoscopic surgery for lung cancer[J].Surg Today,2017,47(6):718-725. [3] 朱国勇,姜杰,于修义. 不同年度3D与2D胸腔镜肺癌根治术的对比研究[J].中国医师杂志,2017,19(12):1807-1809. [4] PATRICK B,FLORENCE D D,JACQUES H,et al. Complete thoracoscopic lobectomy for cancer:comparative study of three-dimensional high-definition with two-dimensional high-definition video systems[J].Interact Cardiovasc Thorac Surg,2015,20(6):820-823. [5] 中华医学会,中华医学会肿瘤学分会,中华医学会杂志社. 中华医学会肺癌临床诊疗指南(2018版)[J].中华肿瘤杂志,2018,40(12):935-964. [6] 夏漫辉,冷云华,丁学武,等. 胸腔镜下肺段切除术在老年非小细胞肺癌治疗中应用[J].临床军医杂志,2020,48(4):403-404. [7] DZIEDZIC R,MARJANSKI T,BINCZYK F,et al. Favourable outcomes in patients with early-stage non-small-cell lung cancer operated on by video-assisted thoracoscopic surgery:a propensity score-matched analysis[J].Eur J Cardiothorac Surg,2018,54(3):547-553. [8] MIMURA T,YAMASHITA Y,HIRAI Y,et al. Efficacy of complete video-assisted thoracoscopic surgery lobectomy using the three-dimensional endoscopic system for lung cancer[J].Gen Thorac Cardiovasc Surg,2019,68(4):357-362. [9] ELKHOULY A G,SORGE R,ROGLIANI P,et al. Ergonomical assessment of three-dimensional versus two-dimensional thoracoscopic lobectomy[J].Semin Thorac Cardiovasc Surg,2020,32(4):1089-1096. [10] 朱冰,吴迪,李琛,等. 胸腔镜下解剖性肺段切除术与肺叶切除术治疗早期肺癌的临床效果[J].临床和实验医学杂志,2018,17(10):1070-1074. [11] 金澄宇,杨勇伟. 非小细胞肺癌患者胸腔镜与开胸手术前后血清肿瘤标志物及血浆miR相关指标和创伤应激指标变化比较[J].生物医学工程与临床,2018,22(3):327-332. [12] 于占武,刘永煜,杨成良,等. 胸腔镜肺癌根治术患者围术期机体免疫与应激状态变化[J].海南医学院学报,2014,20(4):501-503. [13] 万志华,吴瑞锋,刘伟明,等. 3D胸腔镜肺叶切除术治疗原发性肺癌的疗效分析[J].临床外科杂志,2021,29(3):269-272. [14] 袁伟,刘娜,王宇琛. Flex-3D胸腔镜与2D胸腔镜肺叶切除术治疗原发性肺癌的效果及预后[J].中国临床研究,2020,33(4):461-464.
2022, Vol. 39 
