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Comparison of three-dimensional versus two-dimensional laparoscopic surgery for rectal cancer: a meta-analysis

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Three-dimensional (3D) vision technology has recently been validated for the improvement of surgical skills in a simulated setting. This study assessed the current evidence regarding the efficiency and potential advantages of 3D compared with two-dimensional (2D) laparoscopic rectal surgery for rectal cancer.

Methods

We comprehensively searched PubMed, EMBASE and the Cochrane Library and performed a systematic review and cumulative meta-analysis of all randomized controlled trials (RCTs) and non-randomized controlled trials (nRCTs) assessing the two approaches.

Results

Four trials including a total 331 cases were identified. The positive circumferential resection margins (CRMs) were significantly lower for the 3D group (P = 0.02). The operative time was significantly shorter in the 3D group than in the 2D group (P < 0.00001). There was less estimated blood loss (EBL) in the 3D group than in the 2D group (P = 0.02). Perioperative complication rates, conversion rate, harvested lymph nodes, first flatus, length of stay, pneumonia, wound infection, ileus, anastomotic fistula and urinary retention did not differ significantly between the two groups (P > 0.05).

Conclusions

In summary, 3D laparoscopic rectal surgery appears to have advantages over 2D laparoscopic rectal surgery in terms of positive CRM and operation time; however, it is not better than 2D laparoscopic rectal surgery in terms of the conversion rate and postoperative complications.

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Funding

This work was supported by the National Basic Research Program of China (973 Program) (No. 2015CB554001, JW), the National Natural Science Foundation of China (No. 81472257, YL; No. 81502022, XW), the Natural Science Fund for Distinguished Young Scholars of Guangdong Province (No. 2016A030306002, YL), the Outstanding Young Scholars Supported by Special Program to Cultivate Top Experts in Guangdong Province (No. 2015TQ01R454, YL), the Natural Science Foundation of Guangdong Province (No. 2016A030310222, HY; No. 2018A0303130303, HY), the Science and Technology Program of Guangzhou (No. 2014Y2-00160, JW), the Fundamental Research Funds for the Central Universities (Sun Yat-sen University) (No. 16ykpy35, XW), the Program of Introducing Talents of Discipline to Universities, the National Key Clinical Discipline (2012) and Science and Technology project of Gansu province (No. 18JR3RA05, LF).

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Authors and Affiliations

  1. Department of Anorectal Surgery, Gansu Provincial Hospital, 204 Donggang West Rd., Lanzhou, 730000, Gansu, China

    Laiyuan Li, Xiongfei Yang, Weisheng Zhang & Lili Feng

  2. Department of Colorectal Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China

    Xianhua Gao

  3. Department of Pharmacy, Lanzhou University Second Hospital, Lanzhou, China

    Yinyin Guo

  4. Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

    Yanxin Luo

  5. Department of Neurology, The First Hospital of Lanzhou University, Lanzhou, China

    Yang Luo

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  1. Laiyuan Li
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Correspondence to Lili Feng.

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Li, L., Gao, X., Guo, Y. et al. Comparison of three-dimensional versus two-dimensional laparoscopic surgery for rectal cancer: a meta-analysis. Int J Colorectal Dis 34, 1577–1583 (2019). https://doi.org/10.1007/s00384-019-03353-8

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