Abstract:

Objective To summarize the experience and feasibility of three?dimensional（3D） rotatable laparoscopic anterior resection for rectal cancer and compare with two?dimensional（2D）lapa? roscopy. Methods We retrospectively analyzed 86 cases（from Oct. 2014 to Sep. 2016）of rectal cancer for laparoscopy（40 cases for 3D group and 46 cases for 2D group）. We compared the mean of operation duration, intraoperative blood loss, postoperative exhaust time, postoperative hospital stay, number of lymph node dissection between two groups. Results All cases were performed with laparoscopic procedure. As compared to 2D group, 3D group had less blood loss（35.0±16.8 ml vs. 44.3±18.2 ml, t=-2.449, P=0.016）. No significant differences were seen in operative time（126.2±24.2 min vs. 131.8±30.2 min, t=-0.939, P=0.350）, postoperative exhaust time（2.7±1.2 d vs. 2.8±0.9 d, t=-0.441, P=0.661）, postoperative hospital stay （8.4±2.6 d vs. 8.6±2.5 d, t=- 0.363, P=0.717）, number of lymph node dissection（16.4±3.4 vs. 15.8±5.2, t=0.623, P=0.535）between two groups. Conclusions It is safe to 3D rotatable laparoscopic anterior resection for rectal cancer. Compared with 2D laparoscopy, 3D rotatable laparoscopy is same in flexibility of operation, but it can give us more accurate space orientation, more distinct anatomical layer and more exquisite separation.

Key words: anterior resection, rectal cancer, 3D laparoscopy

摘要：

目的 总结可旋转3D腹腔镜直肠癌前切除手术中的经验，初步探索与2D腹腔镜对比的优势。方法 回顾性分析2014年10月至2016年9月，我院86例行腹腔镜下直肠癌前切除术患者的临床资料，其中3D腹腔镜组40例，2D腹腔镜组46例，对比两种方式在手术时间、术中出血量、术后排气时间、术后平均住院时间、淋巴结清扫数量等指标的差异。结果 86例直肠癌前切除术均在腹腔镜下完成。与2D腹腔镜组相比，3D腹腔镜组具有一定优势，如定位准确层次清晰，术中出血更少（35.0±16.8 mL vs. 44.3±18.2 mL，t=-2.449，P=0.016）。两组手术时间（126.2±24.2 min vs. 131.8±30.2 min，t=-0.939，P=0.350），术后排气时间（2.7±1.2 d vs. 2.8±0.9 d，t=-0.441，P=0.661），术后住院时间（8.4±2.6dvs.8.6±2.5d，t=-0.363，P=0.717），淋巴结清扫数量两组间（16.4±3.4个vs.15.8±5.2个，t=0.623，P=0.535）均无显著差异。结论 可旋转3D腹腔镜应用于腹腔镜直肠癌前切除手术是安全可行的，可旋转3D腹腔镜与2D腹腔镜有着一样的操作灵活性，但其空间定位更加准确，解剖层次更加清晰，分离更为精细。

关键词: 直肠癌前切除术 , 3D 腹腔镜, 直肠癌