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三维(3D)腹腔镜与二维(2D)腹腔镜:单外科医生前瞻性随机对照研究。

Three-Dimensional (3D) Laparoscopy Versus Two-Dimensional (2D) Laparoscopy: A Single-Surgeon Prospective Randomized Comparative Study.

机构信息

Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, China.

出版信息

Asian Pac J Cancer Prev. 2020 Oct 1;21(10):2883-2887. doi: 10.31557/APJCP.2020.21.10.2883.

Abstract

BACKGROUND

Visual information is crucial for performing laparoscopic surgery. While surgeons lose depth perception and spatial orientation in conventional 2D laparoscopy, the 4th generation 3D system gives a better depth perception.

OBJECTIVE

In this sstudy, we aimed to investigate the feasibility, safety, and short-term efficacy of 4th generation 3D-HD visualization technology applied in laparoscopic colon cancer surgery.

METHODS

One hundred and twenty patients with colon adenocarcinoma were recruited in this study. Patients were randomized on the day of surgery by a random computer-generated allocation list to undergo either a 3D-HD display or 2D-HD imaging system laparoscopic colon cancer surgery. In total, 60 patients underwent laparoscopic colon resection by 3D-HD laparoscope (3D group) and 60 patients underwent 2D-HD laparoscope (2D group). After the insertion of the access ports, both surgical procedures were divided in component tasks, and the execution times were compared. Data analysis was done using SPSS (version 15.0). Quantitative and qualitative variables were compared applying Student t test and Pearson's chi-square test.

RESULTS

Two groups were homogenous in terms of demographic data. Operation time was significantly shorter for the 3D group than for the 2D group (123.2±34.2 min vs. 142.2±23.5 min, P=0.018). There was no statistically significant difference between two groups in terms of intraoperative blood loss, the number of retrieved lymph nodes, postoperative recovery, and postoperative complications (P>0.05).

CONCLUSION

The 4th generation 3D-HD vision system reduced the operating time compared to 2D-HD vision system. It seems that use of the 3D-HD technology can significantly enhance the possibility of achieving better intraoperative results. 
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摘要

背景

视觉信息对于执行腹腔镜手术至关重要。虽然传统的 2D 腹腔镜手术会使外科医生失去深度感知和空间方位感,但第四代 3D 系统可提供更好的深度感知。

目的

本研究旨在探讨第四代 3D-HD 可视化技术在腹腔镜结肠癌手术中的可行性、安全性和短期疗效。

方法

本研究纳入了 120 例结肠癌腺癌患者。患者在手术当天通过随机计算机生成的分配列表随机分为 3D-HD 显示器或 2D-HD 成像系统腹腔镜结肠癌手术组。共有 60 例患者接受了 3D-HD 腹腔镜(3D 组)下腹腔镜结肠癌切除术,60 例患者接受了 2D-HD 腹腔镜(2D 组)下腹腔镜结肠癌切除术。在插入进入端口后,将两种手术程序分为组件任务,并比较执行时间。使用 SPSS(版本 15.0)进行数据分析。使用 Student t 检验和 Pearson 卡方检验比较定量和定性变量。

结果

两组在人口统计学数据方面具有同质性。3D 组的手术时间明显短于 2D 组(123.2±34.2 min 比 142.2±23.5 min,P=0.018)。两组在术中出血量、淋巴结检出数、术后恢复和术后并发症方面无统计学差异(P>0.05)。

结论

与 2D-HD 视觉系统相比,第四代 3D-HD 视觉系统可缩短手术时间。似乎使用 3D-HD 技术可以显著提高实现更好的术中结果的可能性。

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