[Application of three-dimensional laparoscopic system in obturator lymph node dissection of progressive rectal...

To compare the handling and efficacy between three-dimensional(3D) imaging system and two-dimensional(2D) imaging system for laparoscopic surgery of rectal cancer deep obturator lymph node dissection.

Clinical data of 36 patients who underwent rectal cancer resection and obturator lymph node dissection with 3D or 2D imaging system from January 2013 to May 2014 in our department were retrospectively analyzed. There were 16 cases and 20 cases in 3D group and 2D group respectively. Completion time of obturator lymph node dissection, total operation time, total number of lymph node dissected, number of wrong grasping (more than twice for correct positioning in the same site) times and blood loss during obturator lymph node dissection were compared between two groups.

The laparoscopic rectal cancer resections were successfully completed without laparotomy in both groups. The completion time of obturator lymph node dissection was (23.5 ± 2.5) min and (25.0 ± 3.0) min respectively (P<0.05); the number of wrong grasping was 5.0 ± 2.0 and 6.0 ± 4.0(P<0.01); the blood loss during obturator lymph node dissection was (15.5 ± 1.5) ml and (17.5 ± 2.5) ml (P<0.01). The differences were all statistically significant. The total operation time of 3D and 2D group was (206.0 ± 26.0) min and (222.5 ± 27.5) min (P<0.05); the total number of lymph node dissected was 24 ± 6 and 21 ± 9 (P<0.05). The differences were statistically significant as well. Six cases in 3D group and 11 cases in 2D group were followed up for 1 year and there was no tumor recurrence or death case.

3D laparoscopic technique has more obvious advantages as compared with 2D laparoscopic system in rectal cancer deep obturator lymph node dissection, so it is worthy to spread.