Abstract: Objective:To compare the clinical effect of threedimensional (3D) and twodimensional (2D) imaging systems in laparoscopic radical resection of rectal cancer.
Methods:The retrospective cohort study was adopted. The clinical data of the 97 patients who underwent laparoscopic radical resection of rectal cancer at the Xinmin Branch of the ChinaJapan Union Hospital of Jilin University between May 2012 and December 2014 were collected. Of 97 patients, 47 undergoing 3D laparoscopic radical resection of rectal cancer were allocated into the 3D group and 50 undergoing 2D laparoscopic radical resection of rectal cancer were allocated into the 2D group. The operation followed strictly tumorfree and total mesorectal excision principles. Observation indicators included: (1) surgical situations: operation time, time of deep lymph nodes dissected, volume of intraoperative blood loss, bleeding volume of obturator lymph nodes dissected, number of lymph nodes dissected, postoperative complications and duration of hospital stay. (2) Followup situations: followup using outpatient examination and telephone interview was performed to detect the survival of patients and tumor recurrence and metastasis up to December 2015. Measurement data with normal distribution were presented as ±s and comparison between groups was analyzed using the t test. Count data were analyzed using the chisquare test.
Results:(1) Surgical situations: all the patients underwent successful laparoscopic radical resection of rectal cancer, without conversion to open surgery. Operation time, time of deep lymph nodes dissected, volume of intraoperative blood loss, bleeding volume of obturator lymph nodes dissected, number of lymph nodes dissected and duration of postoperative hospital stay were (134.6±18.5)minutes, (21.2±2.7)minutes, (65±20)mL, (16±3)mL, 23.6±3.5, (8.2±2.3)days in the 3D group and (157.4±17.8)minutes, (25.2±2.5)minutes, (89±27)mL, (23±5)mL, 20.5±2.8, (9.4±2.1)days in the 2D group, respectively, with statistically significant differences between the 2 groups (t=2.999, 3.739, 2.327, 4.221, 2.337, 1.274, P<0.05). The postoperative complications were detected in 7 patients in the 3D group and 9 patients in the 2D group, with no statisfically significant difference between the 2 groups (χ²=0.170, P>0.05). (2) Followup situations: 75 of 97 patients were followed up for 12-36 months with a median time of 24 months, including 35 in the 3D group and 40 in the 2D group, and they were tumorfree survival.
Conclusion:Compared with 2D laparoscopic radical resection of rectal cancer, 3D laparoscopic radical resection of rectal cancer can shorten the operation time and reduce tissue damage and intraoperative blood loss, and it is beneficial to deep lymph node dissection.