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2D vs 3D laparoscopic right colectomy:A propensity score-matching comparison of personal experience with systematic review and meta-analysis

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World Journal of Gastrointestinal Surgery 2021年第6期13卷 597-619页

作者： Gianluca Costa Pietro Fransvea Luca Lepre Fabio Rondelli Alessandro Costa Michela Campanelli Giorgio Lisi maria Rosaria Mastrangeli giovanni Guglielmo Laracca giovanni maria garbarino Graziano Ceccarelli Surgery Center Campus Bio-MedicoRome 00128Italy Department of Emergency and Trauma Surgery Fondazione Policlinico Universitario A.Gemelli IRCCSRome 00168Italy General Surgery Unit Santo Spirito in Sassia HospitalRome 00193Italy Department of Surgical Science University of PerugiaSanta Maria Teaching HospitalTerni 05100Italy Catholic University“Our Lady of Good Council”School of Medicine Tirane 1023Albania Department of Emergency Surgery Tor Vergata University HospitalRome 00133Italy Department of General Surgery Sant'Eugenio HospitalRome 00144Italy Department of Medical Surgical Science and Translational Medicine Sapienza University of RomeSant'Andrea HospitalRome 00189Italy General Surgery Unit San Giovanni Battista HospitalFoligno 06034Italy

BACKGROUND The benefits of laparoscopic approach for right colectomy have been well ***,the technical difficulty to construct the intra-corporeal anastomosis is still *** To analyze the results of 3D and 2D laparoscopic right colectomy and to compare it to the published series through a systematic review and *** A retrospective study with propensity score matching analysis of patients undergoing laparoscopic right colectomy at Umbria2 Hospitals from January 2014 to March 2020 was performed.A systematic review was accomplished comparing 2D and 3D right *** In the personal series 47 patients of the 2D group were matched to 47 patients of the 3D *** 3D group showed a favorable trend in terms of mean operative time(170.7±32.9 min vs 183.8±35.4 min;P=0.053)and a significant lower anastomotic time(16.9±2.3 min vs 19.6±2.9 min,P<0.001).The complete mesocolic excision(CME)subgroups analysis showed a shorter anastomotic time(16.5±1.8 min vs 19.9±3.0 min;P<0.001)and operative time(175.0±38.5 min vs 193.7±37.1 min;P=0.063)in the 3D *** studies and our series were included in the meta-analysis with 551 patients(2D group:291;3D group:260).The pooled analysis demonstrated a significant difference in favour of the 3D group regarding the operative time(P<0.001)and the anastomotic time(P<0.001)while no differences were identified between groups in terms of blood loss(P=0.827),LNH yield(P=0.243),time to first flatus(P=0.333),postoperative complications(P=0.718)and length of stay(P=0.835).CONCLUSION The meta-analysis results showed that 3D laparoscopic right colectomy shortens operative and anastomotic time without affecting the standard *** our series,the advantage of the 3D system becomes evident when CME and/or more complex associated procedure are requested significantly reducing both the total operative and the anastomotic time.

关键词： Colon cancer Right colectomy Laparoscopy Complete mesocolic excision Two-dimensional Three-dimensional

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