A Randomized Controlled Trial With 3D System And Traditional 2D System In Laparoscopic Colorectal Surgery

Objective: To investigate the operative technique,postopertaive recovery,feasibility and safety of the 3D laparoscopy system in colorectal surgery.Methods: The Clinical and follow-up data of 74 patients with colorectal carcinoma who underwent laparoscopic radical resection in Shanghai Minimally Invasive Surgery Center between November 2013 and June 2015 were analyzed prospectively.According to random number table,74 patients were divided into the following groups: 2D laparoscopy system group and 3D laparoscopy system group.In the 38 cases of 2D laparoscopy system group(20 males,18 females),the average age was 60.5(range 46-83 years);In the 36 cases of 3D laparoscopy system group(16 males,20 females),the average age was 62(range 37-84 years).In the 2D laparoscopy system group,there were 12 cases of cases of laparoscopic right hemicolectomies,4 cases of laparoscopic left hemicolectomies,1 case of laparoscopic transverse colectomy,2 cases of laparoscopic sigmoidectomies,17 cases of laparoscopic radical resections of rectal carcinoma(3 cases with ileostomies)and 2 cases of aparoscopic abdominoperineal radical resections of the rectum;In the 3D laparoscopy group,there were 15 cases of laparoscopic right hemicolectomies,3 cases of laparoscopic left hemicolectomies,1 case of laparoscopic transverse colectomy,3 cases of laparoscopic sigmoidectomies,10 cases of laparoscopic radical resections of rectal carcinoma(5 cases with ileostomies)and 4 cases of laparoscopic abdominoperineal radical resections of the rectum.The outcome measures included:(1)Clinical datas:general health condition of the patients,operative data,postoperative recovery data and postoperative pathological data;(2)Subjective questionnaires for surgeons: The design references of the questionnaire were ―ITU-R BT500‖ and ―ITU—R BT.1438‖ pubilished by United Nations specialized agency for information and communication technologies.Results:(1)Clinical data: There was no conversion to open,intraopertaive complications or opertaion related death.In the 2D laparoscopy group,the mean operation time was 153.3±54.9min,and the mean blood loss was 117.9±102.5ml.The mean flatus time was 2.3±0.9 days,and the mean hospitalization days was 9.6±7.8 days.In the 3D laparoscopy group,the mean operation time was 152.9±48.3min(p=0.973),and the mean blood loss was 100.3±66.3ml(p=0.386).The mean flatus time was 2.1±0.8 days(p=0.228),and the mean hospitalization days was 8.1±3.2 days(p=0.289).(2)The result of subjective questionnaire for surgeons: Every surgeons were required to answered the questionnaires of evaluating 2D and 3D system within 2 hours after surgery.There were 85 questionnaires retrieved.There were 32 questionnaires in the group of 2D laparoscopy system and 53 questionnaires in the group of 3D laparoscopy system.The statistical result of questionnaires shows that the ophthalmic fatigue degree of 2D laparoscopy system was 4.6±0.5 points out of a possible 5 and the degree of ophthalmic vertigo was 4.9±0.7 points.The control coordination degree of visual angle was 4.7±0.6 points and the depth description was 3.9±0.8 points.In the group of 3D laparoscopy system,the score of ophthalmic fatigue degree was 4.3±0.8 points(p=0.038)and the degree of ophthalmic vertigo was 4.5±0.7 points(p=0.000).The control coordination degree of visual angle was 4.2±0.8 points(p=0.024)and the depth description was 4.4±0.7 points(p=0.003).In the 2D laparoscopy group,there were complications in 2 cases with anastomotic leakage in the group of laparoscopic right hemicolectomy and laparoscopic radical resections of rectal carcinoma;In the 3D laparoscopy group,there was a complication in 1 case with wound infection in the group of laparoscopic abdominoperineal radical resections of the rectum.Conclusions: We concluded that the 3D laparoscopy system was similar to the traditonal 2D laparoscopy system in surgical procedures and clinical effects.3D laparoscopy system got slightly lesser scores in the ophthalmic fatigue degree,the degree of ophthalmic vertigo and the control coordination degree of visual angle contrast with the 2D laparoscopy system.However,3D laparoscopy system got more score in the depth description.Nevertheless,more studies with larger sample are required to evaluate the impact of 3D laparoscopy system.