The Therapeutic Effectiveness of 3-dimensional Video-assisted Thoracic Surgery in the Management of Oesophageal Cancer.

OBJECTIVES

The comparative benefits of 3-dimensional (3D) versus 2-dimensional (2D) video-assisted thoracic surgery (VATS) for oesophageal cancer remain uncertain. This meta-analysis aims to assess the efficacy and safety profiles of 3D and 2D VATS procedures in the management of oesophageal cancer.

METHODS

A comprehensive literature search was conducted utilizing the PubMed, Cochrane Library, and China National Knowledge Infrastructure (CNKI) databases for studies published up to August 2025. Eligible studies were those comparing the efficacy and safety profiles of 3D versus 2D VATS. For data synthesis, continuous variables were evaluated using standardized mean differences (SMD), while dichotomous outcomes were assessed with odds ratios (ORs); all effect measures are reported with 95% confidence intervals (CIs) and corresponding P-values.

RESULTS

Eight studies involving 1273 patients (608 undergoing 3D VATS and 665 undergoing 2D VATS) demonstrated that the 3D VATS approach was associated with significantly decreased intraoperative blood loss (-2.27; 95% CI: -3.45 to -1.09; P < .05) and reduced operative duration (-0.65; 95% CI: -1.15 to -0.16; P < .05) compared to the 2D technique. However, no statistically significant differences were observed between the 2 groups in terms of postoperative drainage time, postoperative hospitalization duration, total postoperative drainage volume, incidence of postoperative complications, and number of lymph node dissection.

CONCLUSIONS

This meta-analytic study demonstrates that potential clinical benefits of 3D VATS over the 2D approach for oesophageal cancer resection, such as decreased intraoperative blood loss and reduced operative duration.