Comparative Study of Clinical Efficacy Using Three-dimensional and Two-dimensional Laparoscopies in the Treatment of Distal Gastric Cancer

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Three-dimensional (3D) laparoscopic-assisted radical gastrectomy for distal advanced gastric cancer has similar safety and feasibility to 2-dimensional (2D) laparoscopic surgery, results of this study have shown.

Although 2D laparoscopic procedures for gastric cancers have the advantages of being minimally invasive and as effective as open procedures, it is not without its challenges. Lymphadenectomy is the standard for surgical treatment of gastric tumors, but the perigastric vasculature is complex and oftentimes many gastric cancer lymph nodes must be removed, making 2D laparoscopy-assisted surgery difficult due to the lack of stereoscopic vision.

Advancements in laparoscopic practice have led to the development of 3D laparoscopy, reducing the shortcomings of 2D procedures and providing surgeons with 3D vision. Previous studies found no significant differences between 2D and 3D surgeries in operative time, intraoperative blood loss, number of lymph node dissections, and postoperative complication rates.

For this study, the authors investigated the short-term effects and feasibility of 3D laparoscopic-assisted radical gastrectomy for advanced gastric cancer. 

OncoTargets and Therapy
OncoTargets and Therapy

Background: Three-dimensional (3D) laparoscopy has the advantages and characteristics of more radical procedures in the treatment of gastric cancer. The objective of this research was to investigate the short-term efficacy and safety of 3D laparoscopic procedures in the treatment of advanced distal gastric cancer.

Methods: We retrospectively analyzed the clinical data of 124 patients treated with 3D and two-dimensional (2D) laparoscopic D2 lymphadenectomy for distal gastric cancer at the China Academy of Medical Sciences Cancer Hospital and the Affiliated Cancer Hospital of Guangxi Medical University from January 2014 to January 2015. The effects on operative time, bleeding, hospitalization time, complications, and the number of lymph nodes removed were analyzed.

Results: The difference between the general data of the two groups was not statistically significant (P>0.05). In analysis of the subgroups, the number of lymph nodes removed in the 3D laparoscopic group was significantly higher than in the 2D laparoscopic group ([2.52±1.88] vs [2.22±1.80], P=0.001; [2.22±1.80] vs [1.47±1.99], P=0.019). However, the differences among the total number of lymph nodes removed, operative time, intraoperative blood loss, intraoperative complications, postoperative complications, postoperative recovery time, and postoperative hospital stay were not statistically significant.

Conclusion: 3D laparoscopic-assisted radical gastrectomy for distal advanced gastric cancer is safe and feasible.


Keywords: laparoscopic gastrectomy, D2 lymphadenectomy, gastric neoplasm, imaging, 3D laparoscopy 

INTRODUCTION

Laparoscopic procedures for early gastric cancer were first reported by Kitano et al1 in 1994. Since then, laparoscopic gastrectomy for cancer has been used worldwide because of its remarkable advantages of being a minimally invasive procedure and having a radical effect similar to that of open procedures.2–7 Perigastric vascular anatomy is complicated, and often a wide range of gastric cancer lymph nodes must be removed. However, lymphoscintigrams are displayed as planar images in two-dimensional (2D) laparoscopic procedures. Therefore, performing perigastric lymphadenectomy can be difficult, requiring surgeons who have extensive experience in procedures and excellent operating skills. With the development of the laparoscopic technique, three-dimensional (3D) laparoscopy has overcome the shortcomings of traditional laparoscopic procedures and now provides surgeons with 3D visions. Generally, 3D laparoscopy has the advantages and characteristics of radical gastric cancer procedures. This study aimed to investigate the feasibility and short-term effects of 3D laparoscopic-assisted radical gastrectomy for distal advanced gastric cancer.

 

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