| Background:With the concept of minimally invasive surgery and the development of technology,minimally invasive surgery,reduce intraoperative bleeding,accelerate the recovery of patients,so laparoscopic technology is widely used in clinical.However,advanced laparoscopic surgery is still a high challenge.One of the major problems is the lack of stereo vision.Despite its spread,laparoscopic right hemicolectomy remains controversial.There are still considerable difficulties in the treatment process,especially in the formation of ileocolonic anastomosis.Laparoscopic 3D imaging technology is introduced to overcome the lack of depth perception and spatial and positioning limitations of traditional 2D imaging High definition and ultra-high-definition imaging technology did not improve the significant limitations of two-dimensional(2D)laparoscopy in depth perception and spatial orientation.In recent years,laparoscopic three-dimensional(3D)imaging technology overcomes the above limitations of conventional two-dimensional(2D)imaging technology,but 3D laparoscopy does not show subversive advantages in surgical effect,and this method has not been widely accepted.At present,there are few reports comparing the safety and effectiveness of 2D and 3D laparoscopic technique in right hemicolectomy,and the application of 3D laparoscopic technique in right hemicolectomy is still controversial.Objective:In this study,a retrospective analysis was performed to the effect of Application of 3D laparoscopy in elective laparoscopic right colon cancer hemicolectomy and to evaluate its advantages and disadvantages compared with conventional 2D laparoscopy.Methods:According to the inclusion and exclusion criteria,Northern jiangsu people’s hospital was screened for the treatment of patients with right-sided colon cancer hemicolectomy using 3D laparoscopy and 2D laparoscopy from September 2018 to March 2021.A retrospective analysis was performed,and 200 patients were included.The general information,intraoperative data,postoperative recovery,postoperative complications,and patient satisfaction were analyzed and compared.Results:General information:There was no significant difference in gender,age and body mass index(BMI),and distant metastasis between the two groups(P>0.05).Intraoperative data:the average operation time of the 2D group was 152.3±37.7(min)and the 3D group was 126.7±24.3(min),with significant difference(P=0.001);the intraoperative blood loss of the 2D group was 91.3±100.7(ML),and the 3D group was 48.5±23.6(ML),with significant difference(P=0.001).Postoperative recovery:the anal defecation recovery time of the 2D group was 4.9±1.6(d),and the 3d group was 4.5±1.4(d),no significant difference(P=0.070),the recovery time of eating food of the 2D group was 5.9±1.5(d),and the 3D group was 5.7±1.2(d),no significant difference(P=0.476).The postoperative hospital stay of the 2D group was 12.6±4.4(d),and the 3D group was 10.5±2.0(P=0.001).Operation time,blood loss,recovery time,and postoperative hospital stay significant differences between the two groups.Pathological index data analysis:Pathological index:T1-T2 there have 29 cases(24.2%)in the 2D group and 16 cases(20%)in the 3D group,T3-T4 there have 91 cases(75.8%)in 2D group and 64 cases(80%)in the 3D group and there was no significant difference in T stage composition between the two groups(P=0.478);the average positive lymph nodes of the 2D group was 2.1 ± 0.4,and the 3D group was 3.2 ± 0.6,with no significant difference(P=0.034);the EXAMINED lymph nodes of the 2D group was 15.2±1.1,and the 3D group was 18.1 ±1.3,with no significant difference(P=0.001).T stage significant difference between the two groups.Routine blood test data analysis:Preoperative conditions:the average HGB of the 2D group was 116.7±27.4(g/L),and the 3Dgroup was 119.3±27.5(g/L),with no significant difference(P=0.513);the WBC of the 2D group was 6.6±2.7(x109/L),and the 3D group was 6.5±2.6(x109/L),with no significant difference(P=0.795);the NE of the 2D group was 64.7± 10.6(percent),and the 3D group was 66.±10.8(percent),with no significant difference(P=0.275).Postoperative conditions:the average HGB of the 2D group was 110.5±23.8(g/L)and the 3D group was 112.9±21.8(g/L),with no significant difference(P=0.471);the WBC of the 2D group was 9.8±3.5(x109/L)and the 3D group was 9.4±3.3(x109/L),with no significant difference(P=0.419);the NE of the 2D group was 82.6±8.5(percent)and the 3D group was 81.5±8.8(percent),with no significant difference(P=0.338).NE was a significant difference in preoperative between the two groups.Postoperative complications:Regarding postoperative complications,only 1 case(0.8%)of anastomotic leakage occurred in the 2D group,and the difference was not statistically significant(P=0.600);in the two groups;3 cases(2.53%)of bowel obstruction in the 2D group and 2 cases(2.5%)in the 3d group,and the difference was not statistically significant(P=0.684);in general,the incidence of postoperative complications in the two groups were 3.3%and 2.5%,respectively.Postoperative complications in the gastrojejunostomy group were no significant between the two groups(P=0.544).Satisfaction level:There were 3(2.5%)patients with the 2D group and their families were very satisfied,115(95.8%)were satisfied,1(0.8%)were dissatisfied,and 1(0.8%)were very dissatisfied,while 3(3.8%)patients with the 3D group and their families were very dissatisfied,76(95.0%)were very satisfied,and 1(1.3%)were dissatisfied.It can be seen that patients and their families were more satisfied with the treatment effect after the 3D group.The difference was not statistically significant(P=0.800).Conclusion:Compared with 2D laparoscopic surgery,3D laparoscopic right hemicolectomy not only shortened the operation time,reduced intraoperative blood loss and hospital stay,but also increased the total number of lymph node dissection and the number of positive lymph nodes.However,due to the limited number of sample in this study,large sample prospective cohort studies are still needed to confirm the better surgical effect of 3D laparoscopy in right hemicolectomy. |
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