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. 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. 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   0.05). 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.

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

Objective
To investigate the clinical effects and advantages of flexible 3D laparoscopic surgery on rectal cancer after neoadjuvant chemoradiotherapy (nCRT).


Methods
The data of 152 patients who received laparoscopic rectal cancer resection after nCRT excluding the cases of high rectal cancer, cardiac and pulmonary dysfunction were analyzed from January 2015 to January 2016 in the Department of Colorectal Surgery of Liaoning Cancer Hospital. The distances from the annal edge to the inferior tumor margin were within 8 cm in these patients. Among these patients, 76 cases received the 3D laparoscopic surgery after nCRT (3D-nCRT), and 76 cases undergone the 2D laparoscopic surgery after nCRT (2D-nCRT).


Results
Between two groups, the number of lymph node harvest (14.8±2.1 vs. 14.3±1.7), positive rate of the distal margin [1.3% (1/76) vs. 2.6% (2/76)], reserving anus rate [92.1% (70/76) vs. 81.2% (67/76)], local recurrence rate [1.3% (1/76) vs. 3.9% (3/76)] and anastomotic leakage rate [2.6% (2/76) vs. 3.9% (3/76)] had no statistical differences (all P > 0.05), while the operative time [(125.3±10.2) min vs. (136.6±12.0) min], intraoperative bleeding [(54.1±23.2) ml vs. (61.9±19.5) ml], anus exhaust time [(43.5±5.0) h vs. (45.4±5.6) h] and positive rate of circumferential resection margin (CRM) [1.3% (1/76) vs. 9.2% (7/76)] had statistical differences (all P < 0.05).


Conclusion
Flexible 3D laparoscopic surgery on rectal cancer after nCRT can shorten operative time, reduce intraoperative bleeding, alleviate the influence of intestinal peristalsis function,and improve operative quality.


Key words: 
3D Laparoscopy; Rectal neoplasms; Laparoscopic surgery; Neoadjuvant chemoradiotherapy; Surgical procedures, minimally invasive

Effect of flexible 3D laparoscopic surgery on rectal cancer after neoadjuvant chemoradiotherapy

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Effect of flexible 3D laparoscopic surgery on rectal cancer after neoadjuvant chemoradiotherapy