The efficacy of 3D laparoscopy in the treatment of colorectal cancer: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

LI Xingwang ¹ , LI Binghui ¹ , MA Linlu ² , WANG Chenyu ¹ , ZHANG Junjie ¹ , WANG Chaoyang ¹ , REN Xuequn ¹ ,  HU Junhong ¹

1. Department of Anorectal, Huaihe Hospital of Henan University; Center for Evidence-Based Medicine, Huaihe Hospital of Henan University; Center for Evidence-Based Medicine, Henan University, Kaifeng, 475000, P.R.China;
2. Center for Evidence-Based Medicine, Henan University of Chinese Medicine, Zhengzhou, 450003, P.R.China;

Corresponding?author：

HU Junhong, Email: hjh-8282@163.com

Keywords：

3D laparoscopy; 2D laparoscopy; Colorectal neoplasm; meta-analysis; Systematic review

DOI：

10.7507/1672-2531.201806067

Video：

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Objectives To systematically review the efficacy and safety of 3D laparoscopic in the treatment of colorectal cancer.Methods PubMed, EMbase, The Cochrane Library, CBM, VIP, WanFang Data and CNKI databases were electronically searched online to collect clinical trials of 3D laparoscopic in the treatment of colorectal cancer from inception to September 1^st, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software.Results A total of 26 trials, including 4 randomized controlled trials and 22 cohort studies were included. The results of meta-analysis showed that: compared with 2D laparoscopic, 3D laparoscopic had shorter operative time (MD=–16.32, 95%CI –22.61 to –10.03, P<0.000 01), less amount of blood transfusion in operation (MD=–10.80, 95%CI –19.93 to –1.66, P=0.02), more lymph node dissection (MD=0.88, 95%CI 0.30 to 1.45, P=0.003), shorter recovery time of gastrointestinal function (MD=–0.18, 95%CI –0.31 to –0.04, P=0.01), lower incidence of postoperative complication (OR=0.63, 95%CI 0.44 to 0.89, P=0.009), and fewer days in hospital (MD=–0.84, 95%CI –1.40 to –0.28, P=0.003). Additionally, there was no significant difference in hospitalization costs (MD=–0.01, 95%CI –0.23 to 0.21, P=0.94).Conclusions Current evidence shows that, compared with 2D laparoscopy, 3D laparoscopy assisted colorectal cancer surgery has obvious advantages such as less bleeding during operation, shorter operation time, lower incidence of complications after operation, shorter hospitalization time and no increase in hospitalization expenses. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.

Citation： LI Xingwang, LI Binghui, MA Linlu, WANG Chenyu, ZHANG Junjie, WANG Chaoyang, REN Xuequn, HU Junhong. The efficacy of 3D laparoscopy in the treatment of colorectal cancer: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2019, 19(7): 818-827. doi: 10.7507/1672-2531.201806067 Copy

1.	Chen W, Zheng R, Baade PD, et al. Cancer statistics in china 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
2.	Martel G, Crawford A, Barkun JS, et al. Expert opinion on laparoscopic surgery for colorectal cancer parallels evidence from a cumulative meta-analysis of randomized controlled trials. PLoS One, 2012, 7(4): e35292.
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4.	Currò G, La Malfa G, Caizzone A, et al. Three-dimensional (3D) versus two-dimensional (2D) laparoscopic bariatric surgery: a single-surgeon prospective randomized comparative study. Obes Surg, 2015, 25(11): 2120-2124.
5.	Currò G, Cogliandolo A, Bartolotta M, et al. Three-dimensional versus two-dimensional laparoscopic right hemicolectomy. J Laparoendosc Adv Surg Tech A, 2016, 26(3): 213-217.
6.	汪天時, 劉銅軍. 3D 腹腔鏡手術的優勢與應用前景. 中華結直腸疾病電子雜志, 2015, 4(5): 28-31.
7.	馬君俊, 洪希周, 何子銳, 等. 3D 與 2D 腹腔鏡結直腸癌根治術中術者主觀感受的隨機對照研究. 中華消化外科雜志, 2016, 15(9): 892-896.
8.	Foo CC, Law WL. The learning curve of robotic-assisted low rectal resection of a novice rectal surgeon. World J Surg, 2016, 40(2): 456-462.
9.	池畔, 陳致奮. 腹腔鏡不同途徑與方法行全直腸系膜切除質量控制評價. 中國實用外科雜志, 2016, 36(1): 28-33.
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20.	費秉元, 姜俊男, 房學東, 等. 3D 與 2D 腹腔鏡直腸癌根治術的療效分析. 中華消化外科雜志, 2016, 15(8): 785-788.
21.	張慶彤, 劉亞莉, 張旭, 等. 3D 與 2D 腹腔鏡手術治療新輔助放化療后直腸癌的療效分析. 中華消化外科雜志, 2017, 16(8): 850-855.
22.	張慶彤, 劉亞莉, 張旭, 等. 可彎曲 3D 腹腔鏡手術治療新輔助放化療后直腸癌臨床效果分析. 腫瘤研究與臨床, 2017, 29(2): 112-115, 128.
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29.	曾兵, 蔡燦鋒, 辛海洋, 等. 3D 腹腔鏡在右半結腸癌全結腸系膜切除術中的應用. 嶺南現代臨床外科, 2017, 17(1): 30-33.
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31.	郭欣, 呂小慧, 張珂誠, 等. 3D 與 2D 腹腔鏡直腸癌根治術的療效對比分析. 中華胃腸外科雜志, 2017, 20(10): 1190-1191.
32.	季福建, 房學東, 費秉元. 3D 與 2D 腹腔鏡胃腸道腫瘤手術的比較研究. 中華胃腸外科雜志, 2017, 20(5): 509-513.
33.	李志澄, 彭翔, 計勇, 等. 比較 3D 腹腔鏡和 2D 腹腔鏡下直腸癌全直腸系膜切除術治療直腸癌對患者術后并發癥影響. 中國現代藥物應用, 2017, (15): 42-43.
34.	屈鵬, 宋林杰, 那興邦, 等. 3D 與傳統 2D 腹腔鏡輔助直腸癌 Dixon 術臨床對比研究. 中華腔鏡外科雜志(電子版), 2017, 10(5): 307-310.
35.	陶國全, 錢燕, 于仁, 等. 3D 腹腔鏡在右半結腸癌根治術中的應用. 中國微創外科雜志, 2017, 17(7): 609-611, 626.
36.	王鄧超, 余淼, 楊玉輝, 等. 三維腹腔鏡在保留盆腔自主神經的直腸癌根治術中的應用. 中華腔鏡外科雜志(電子版), 2017, 10(1): 46-49.
37.	肖曠, 鄭勇斌, 童仕倫, 等. 3D 腹腔鏡在直腸癌根治術中的臨床應用探究. 臨床急診雜志, 2017, 18(12): 895-898.
38.	辛海洋, 曾兵, 蔡燦鋒, 等. 3D 腹腔鏡與 2D 腹腔鏡在乙狀結腸癌根治術中應用的近期療效對比分析. 消化腫瘤雜志(電子版), 2017, 9(2): 99-102.
39.	龔鋮, 劉權焰, 張進, 等. 腹腔鏡結直腸癌手術療效及安全性的系統評價. 中華外科雜志, 2011, 49(4): 346-350.
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1. Chen W, Zheng R, Baade PD, et al. Cancer statistics in china 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
2. Martel G, Crawford A, Barkun JS, et al. Expert opinion on laparoscopic surgery for colorectal cancer parallels evidence from a cumulative meta-analysis of randomized controlled trials. PLoS One, 2012, 7(4): e35292.
3. 張春燕, 孫莉. 3D 腹腔鏡在胃癌手術中的應用效果及安全性的Meta分析. 中國普通外科雜志, 2016, 25(10): 1381-1387.
4. Currò G, La Malfa G, Caizzone A, et al. Three-dimensional (3D) versus two-dimensional (2D) laparoscopic bariatric surgery: a single-surgeon prospective randomized comparative study. Obes Surg, 2015, 25(11): 2120-2124.
5. Currò G, Cogliandolo A, Bartolotta M, et al. Three-dimensional versus two-dimensional laparoscopic right hemicolectomy. J Laparoendosc Adv Surg Tech A, 2016, 26(3): 213-217.
6. 汪天時, 劉銅軍. 3D 腹腔鏡手術的優勢與應用前景. 中華結直腸疾病電子雜志, 2015, 4(5): 28-31.
7. 馬君俊, 洪希周, 何子銳, 等. 3D 與 2D 腹腔鏡結直腸癌根治術中術者主觀感受的隨機對照研究. 中華消化外科雜志, 2016, 15(9): 892-896.
8. Foo CC, Law WL. The learning curve of robotic-assisted low rectal resection of a novice rectal surgeon. World J Surg, 2016, 40(2): 456-462.
9. 池畔, 陳致奮. 腹腔鏡不同途徑與方法行全直腸系膜切除質量控制評價. 中國實用外科雜志, 2016, 36(1): 28-33.
10. 所劍, 張洋, 李偉. 3D 高清腹腔鏡在低位直腸癌根治術中的應用. 中華消化外科雜志, 2016, 15(9): 878-881.
11. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ, 2009, 339: b2535.
12. Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605.
13. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0. The Cochrane Collaboration, 2011. Available at: www.handbook.cochrane.org.
14. Zeng Q, Lei F, Gao Z, et al. Case-matched study of short-term effects of 3D vs 2D laparoscopic radical resection of rectal cancer. World J Surg Oncol, 2017, 15(1): 178.
15. 洪希周, 馬君俊, 董峰, 等. 3D 與 2D 腹腔鏡系統在結直腸癌手術應用的隨機對照研究. 腹部外科, 2017, 30(1): 23-26, 35.
16. 區穎豪, 粱麗婷, 陳曉, 等. 直腸癌進展期應用 3D 腹腔鏡行根治性手術的臨床觀察. 中國醫學創新, 2017, 14(14): 32-35.
17. 丁元升, 田相安, 孫欽立, 等. 3D 與 2D 腹腔鏡下保留左結腸動脈的直腸癌根治術的臨床對照研究. 飲食保健, 2018, 5(3): 22-23.
18. Tao K, Liu X, Deng M, et al. Three-dimensional against 2-dimensional laparoscopic colectomy for right-sided colon cancer. Surg Laparosc Endosc Percutan Tech, 2016, 26(4): 324-327.
19. 白軍偉, 張超, 薛煥洲. 3D 與 2D 腹腔鏡結直腸癌根治術的療效分析. 中華消化外科雜志, 2016, 15(9): 897-901.
20. 費秉元, 姜俊男, 房學東, 等. 3D 與 2D 腹腔鏡直腸癌根治術的療效分析. 中華消化外科雜志, 2016, 15(8): 785-788.
21. 張慶彤, 劉亞莉, 張旭, 等. 3D 與 2D 腹腔鏡手術治療新輔助放化療后直腸癌的療效分析. 中華消化外科雜志, 2017, 16(8): 850-855.
22. 張慶彤, 劉亞莉, 張旭, 等. 可彎曲 3D 腹腔鏡手術治療新輔助放化療后直腸癌臨床效果分析. 腫瘤研究與臨床, 2017, 29(2): 112-115, 128.
23. 陳海金, 俞金龍, 黃宗海, 等. 三維高清腹腔鏡在腹腔鏡直腸癌根治術中的應用. 中華解剖與臨床雜志, 2014, 19(1): 49-50.
24. 季福建, 劉選文, 劉卓, 等. 3D 腹腔鏡系統在進展期直腸癌閉孔淋巴結清掃中的應用. 中華胃腸外科雜志, 2014, 17(11): 1121-1124.
25. 宋京海, 賀修文, 陳劍, 等. 三維技術在腹部外科手術應用的初步經驗. 中國醫刊, 2015, 50(2): 62-64.
26. 于威, 劉銅軍, 李春生, 等. 3D 與 2D 腹腔鏡直腸癌根治術的對比研究. 中華普通外科雜志, 2015, 30(4): 297-299.
27. 宮子建, 馬淑榮, 吉國鋒, 等. 3D 腹腔鏡在進展期直腸癌根治性手術中的應用. 中華普通外科雜志, 2016, 31(6): 506-507.
28. 戚少龍, 陶有茂, 吉國鋒, 等. 3D 與 2D 腹腔鏡右半結腸癌全結腸系膜切除術的臨床療效對比. 中華普通外科雜志, 2016, 31(9): 784-785.
29. 曾兵, 蔡燦鋒, 辛海洋, 等. 3D 腹腔鏡在右半結腸癌全結腸系膜切除術中的應用. 嶺南現代臨床外科, 2017, 17(1): 30-33.
30. 耿巖, 劇永樂, 陸光生, 等. 可旋轉 3D 腹腔鏡在直腸癌前切除術中的臨床體會和特點. 嶺南現代臨床外科, 2017, 17(2): 162-165.
31. 郭欣, 呂小慧, 張珂誠, 等. 3D 與 2D 腹腔鏡直腸癌根治術的療效對比分析. 中華胃腸外科雜志, 2017, 20(10): 1190-1191.
32. 季福建, 房學東, 費秉元. 3D 與 2D 腹腔鏡胃腸道腫瘤手術的比較研究. 中華胃腸外科雜志, 2017, 20(5): 509-513.
33. 李志澄, 彭翔, 計勇, 等. 比較 3D 腹腔鏡和 2D 腹腔鏡下直腸癌全直腸系膜切除術治療直腸癌對患者術后并發癥影響. 中國現代藥物應用, 2017, (15): 42-43.
34. 屈鵬, 宋林杰, 那興邦, 等. 3D 與傳統 2D 腹腔鏡輔助直腸癌 Dixon 術臨床對比研究. 中華腔鏡外科雜志(電子版), 2017, 10(5): 307-310.
35. 陶國全, 錢燕, 于仁, 等. 3D 腹腔鏡在右半結腸癌根治術中的應用. 中國微創外科雜志, 2017, 17(7): 609-611, 626.
36. 王鄧超, 余淼, 楊玉輝, 等. 三維腹腔鏡在保留盆腔自主神經的直腸癌根治術中的應用. 中華腔鏡外科雜志(電子版), 2017, 10(1): 46-49.
37. 肖曠, 鄭勇斌, 童仕倫, 等. 3D 腹腔鏡在直腸癌根治術中的臨床應用探究. 臨床急診雜志, 2017, 18(12): 895-898.
38. 辛海洋, 曾兵, 蔡燦鋒, 等. 3D 腹腔鏡與 2D 腹腔鏡在乙狀結腸癌根治術中應用的近期療效對比分析. 消化腫瘤雜志(電子版), 2017, 9(2): 99-102.
39. 龔鋮, 劉權焰, 張進, 等. 腹腔鏡結直腸癌手術療效及安全性的系統評價. 中華外科雜志, 2011, 49(4): 346-350.
40. Serin KR, Gultekin FA, Batman B, et al. Robotic versus laparoscopic surgery for mid or low rectal cancer in male patients after neoadjuvant chemoradiation therapy: comparison of short-term outcomes. J Robot Surg, 2015, 9(3): 187-194.
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