Comparison of the clinical effectiveness of 3D and 2D imaging systems for laparoscopic radical cystectomy with pelvic lymph node dissection

Abstract

Objective: To compare the clinical effectiveness of three-dimensional (3D) and two-dimensional (2D) laparoscopic imaging systems for radical cystectomy (RC) with pelvic lymph node dissection. Methods: This was a retrospective analysis of data collected from all patients who underwent RC with pelvic lymph node dissection between January 2013 and May 2014, performed by a single surgeon in our clinic. Demographic characteristics and operative data from the procedure were collected and compared. Results: Data were available from 42 patients (mean age 63 ± 6.7 years) of whom 18 were operated on using a 3D imaging laparoscope (Group 3D) and 24 were operated on using a conventional 2D laparoscope (Group 2D). There were no statistically significant differences in patient characteristics between the two groups (P > 0.05). There was no difference between groups in the mean (±SD) number of lymph nodes retrieved from each patient (13.2 ± 4.6 and 12.5 ± 4.3, for the 3D and 2D groups respectively), or in blood loss. PLND duration and total operative time were statistically significantly lower in Group 3D than in group 2D. There were no statistically significant between-group differences in postoperative hospital stay or total cost of the procedures. Serious postoperative complications occurred in one patient (5.6%) in group 3D, and four patients (16.7%) in group 2D (P = 0.075). Conclusions: With the assistance of 3D stereoscopic imaging, surgeons may be able to reduce both the duration of lymph node dissection and overall operative time during laparoscopic RC with pelvic lymph node dissection, without increasing postoperative hospital stay or total cost.