Meta-analysis of three-dimensional versus two-dimensional laparoscopic surgery for rectal cancer

Abstract

Background: Three-dimensional (3D) vision technology has recently been validated for the improvement of surgical skills in a simulated setting. This study to assess 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, Cochrane Library, and performed a systematic review and cumulative meta-analysis of all randomized controlled trials (RCTs) and no randomized controlled trials assessing the two approaches. Results: Four trials including a total of 331 cases were identified. The positive circumferential resection margins (CRM) is significantly lower for 3D (P = 0.02). The operative time was significantly shorter in the 3D group than in the 2D group (P < 0.00001). There were 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, and length of stay did not differ significantly between two approaches (P> 0.05). Conclusions: 3D laparoscopic rectal surgery appear to have advantages over the 2D laparoscopic rectal surgery in terms of operation time and positive CRM, however, it is not better than 2D laparoscopic rectal surgery in terms of EBL and postoperative complications.