Effects of uniportal 3D video-assisted thoracic surgery lobectomy on postoperative pain and immune function in patients with NSCLC.

Objective: This study focused on comparing the efficacy of uniportal three-dimensional (3D) video-assisted thoracic surgery (VATS) lobectomy and traditional two-dimensional (2D) VATS lobectomy in patients with non-small cell lung cancer (NSCLC).

Methods: A retrospective analysis was performed on 84 NSCLC patients who underwent VATS lobectomy. Based on the type of thoracoscope used during surgery, patients were assigned to either the 3D group (n = 42), which received uniportal 3D VATS lobectomy, or the 2D group (n = 42), which underwent traditional 2D VATS lobectomy. Perioperative indicators, postoperative Visual Analog Scale (VAS) scores, pain-related factors [substance P (SP), norepinephrine (NE), and cortisol (COR)], immune function (CD3⁺, CD4⁺, and CD8⁺), lung function [forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and maximal voluntary ventilation (MVV)] were compared between the two groups.

Results: The 3D group exhibited lower intraoperative blood loss, postoperative 24-hour drainage volume, drainage tube indwelling time, surgery duration, and hospitalization time compared to the 2D group (P < 0.05). Postoperatively, the 3D group reported lower VAS scores, lower levels of SP, NE, and COR, higher serum levels of CD3⁺ and CD4⁺, and higher FVC, FEV1, and MVV values compared to the 2D group (all P < 0.05).

Conclusion: Uniportal 3D VATS lobectomy demonstrates clear advantages over traditional 2D VATS lobectomy for NSCLC patients by reducing perioperative pain, minimizing immune impairment, and preserving lung function.