Abstract：
BACKGROUND: Standard laparoscopic colorectal surgery relies on 2D image systems in most centers. However, 3D vision has gained popularity and is used nowadays in a constantly rising number of units. Right hemicolectomy with intracorporeal anastomosis and lymph node dissection represents a surgical procedure that may benefit the most from 3D vision. The aim of the study was to summarize the available literature on the use of 2D vs. 3D video imaging in patients undergoing laparoscopic right hemicolectomy.
METHODS: A comprehensive literature review was conducted including Medline/PubMed, Embase, and Scopus (PROSPERO registration number CRD 42022344764) through October 2022. The systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The risk of bias was evaluated using the ROBINS-I tool. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) guidelines and GRADEpro to develop a summary of evidence tables. Random-effects meta-analyses were conducted.
RESULTS: Five observational retrospective studies (496 patients, 275 2D and 216 3D) were included. One study was rated as having a critical risk of bias; the remaining had low to moderate risk. 2D laparoscopic right hemicolectomy patients showed longer anastomotic time in 3/3 studies (MD = 3.32; 95%CI, 1.58-5.05; p = 0.002) and an upward trend in operative time in 4/5 studies (MD = 9.98; 95%CI, -1.42, 21.37; p = 0.086) compared to 3D. The two image video systems had similar short-term outcomes, including the number of lymph nodes harvested (MD = -0.67; 95%CI, -2.47, 1.13; p = 0.47), morbidity (OR post-operative complications = 1.12; 95%CI, 0.71-1.77; p = 0.62), and length of stay (MD = 0.27; 95%CI, -0.59, 1.13; p = 0.9).
CONCLUSIONS: 2D and 2D laparoscopic right hemicolectomy had similar complications rate, with a shorter anastomotic time along with a downward trend in overall operative time for 3D. Larger prospective randomized trials are awaited before definitive conclusions can be drawn.
METHODS: A comprehensive literature review was conducted including Medline/PubMed, Embase, and Scopus (PROSPERO registration number CRD 42022344764) through October 2022. The systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The risk of bias was evaluated using the ROBINS-I tool. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) guidelines and GRADEpro to develop a summary of evidence tables. Random-effects meta-analyses were conducted.
RESULTS: Five observational retrospective studies (496 patients, 275 2D and 216 3D) were included. One study was rated as having a critical risk of bias; the remaining had low to moderate risk. 2D laparoscopic right hemicolectomy patients showed longer anastomotic time in 3/3 studies (MD = 3.32; 95%CI, 1.58-5.05; p = 0.002) and an upward trend in operative time in 4/5 studies (MD = 9.98; 95%CI, -1.42, 21.37; p = 0.086) compared to 3D. The two image video systems had similar short-term outcomes, including the number of lymph nodes harvested (MD = -0.67; 95%CI, -2.47, 1.13; p = 0.47), morbidity (OR post-operative complications = 1.12; 95%CI, 0.71-1.77; p = 0.62), and length of stay (MD = 0.27; 95%CI, -0.59, 1.13; p = 0.9).
CONCLUSIONS: 2D and 2D laparoscopic right hemicolectomy had similar complications rate, with a shorter anastomotic time along with a downward trend in overall operative time for 3D. Larger prospective randomized trials are awaited before definitive conclusions can be drawn.
摘要：
背景：标准腹腔镜结直肠手术在大多数中心都依赖于2D图像系统。然而,3D视觉已经普及，并且如今在不断增加的单位数量中使用。右半结肠切除术与体内吻合和淋巴结清扫术代表了可能从3D视觉中受益最大的外科手术。这项研究的目的是总结有关2D与2D的使用的现有文献。腹腔镜右半结肠切除术患者的3D视频成像。
方法：进行了全面的文献综述，包括Medline/PubMed，Embase,和Scopus（PROSPERO注册号CRD42022344764）至2022年10月。根据系统评价和荟萃分析（PRISMA）指南的首选报告项目进行系统评价和荟萃分析。使用ROBINS-I工具评估偏倚风险。使用建议分级评估来评估证据的确定性，发展,和评估（GRADE）指南和GRADEPro制定证据表摘要。进行随机效应荟萃分析。
结果：五项观察性回顾性研究（496例患者，包括2752D和2163D）。一项研究被认为具有严重的偏倚风险；其余的风险为低至中等。与3D相比，2D腹腔镜右半结肠切除术患者在3/3研究中吻合时间更长（MD=3.32；95CI，1.58-5.05；p=0.002），在4/5研究中手术时间呈上升趋势（MD=9.98；95CI，-1.42，21.37；p=0.086）。两种图像视频系统的短期结果相似，包括收集的淋巴结数量（MD=-0.67;95CI，-2.47，1.13;p=0.47），发病率（OR术后并发症=1.12;95CI，0.71-1.77;p=0.62），和住院时间（MD=0.27；95CI，-0.59，1.13；p=0.9）。
结论：2D和2D腹腔镜右半结肠切除术的并发症发生率相似，吻合时间较短，3D的总体手术时间呈下降趋势。在得出明确的结论之前，等待更大的前瞻性随机试验。
方法：进行了全面的文献综述，包括Medline/PubMed，Embase,和Scopus（PROSPERO注册号CRD42022344764）至2022年10月。根据系统评价和荟萃分析（PRISMA）指南的首选报告项目进行系统评价和荟萃分析。使用ROBINS-I工具评估偏倚风险。使用建议分级评估来评估证据的确定性，发展,和评估（GRADE）指南和GRADEPro制定证据表摘要。进行随机效应荟萃分析。
结果：五项观察性回顾性研究（496例患者，包括2752D和2163D）。一项研究被认为具有严重的偏倚风险；其余的风险为低至中等。与3D相比，2D腹腔镜右半结肠切除术患者在3/3研究中吻合时间更长（MD=3.32；95CI，1.58-5.05；p=0.002），在4/5研究中手术时间呈上升趋势（MD=9.98；95CI，-1.42，21.37；p=0.086）。两种图像视频系统的短期结果相似，包括收集的淋巴结数量（MD=-0.67;95CI，-2.47，1.13;p=0.47），发病率（OR术后并发症=1.12;95CI，0.71-1.77;p=0.62），和住院时间（MD=0.27；95CI，-0.59，1.13；p=0.9）。
结论：2D和2D腹腔镜右半结肠切除术的并发症发生率相似，吻合时间较短，3D的总体手术时间呈下降趋势。在得出明确的结论之前，等待更大的前瞻性随机试验。
