Abstract：
BACKGROUND: This study aimed to evaluate the effectiveness and safety of 2D laparoscopy vs 3D laparoscopy for the treatment of colorectal cancer.
METHODS: A literature search was conducted through PubMed, Web of Science, and Embase from their inception to January 2024. Studies investigating different outcomes of colorectal surgery were included. Results are presented as odds ratios (ORs) or mean differences (MDs) with 95% confidence intervals (CIs). The protocol for this review has been registered on PROSPERO (CRD42024504902).
RESULTS: A total of 10 publications were retrieved in this article. The 3D group is associated with a significant improvement in intraoperative blood loss (MD = -8.04, 95% CI = -14.18 to -1.89, P = 0.01, I2 = 55%), operative time (MD = -17.33, 95% CI = -29.15 to -5.51, P = 0.004, I2 = 90%), and postoperative hospital stay (MD = -0.23, 95% CI = -0.43 to -0.04, P = 0.02, I2 = 48%) compared to that of patients treated in the 2D group, particularly for rectal cancer patients above three results (MD = -10.36, 95% CI = -15.00 to -5.73, P < 0.001, I2 = 0%), (MD = -18.85, 95% CI = -34.88 to -2.82, P = 0.02, I2 = 57%), and (MD = -0.93, 95% CI = -1.53 to -0.34, P = 0.002, I2 = 0%), respectively. There was no significant statistical difference in the time of pass flatus (MD = -0.14, 95% CI = -0.49 to 0.21, P = 0.44, I2 = 79%) and the number of dissected lymph nodes (MD = 0.36, 95% CI = -0.49 to 1.21, P = 0.41, I2 = 45%), but the 3D group had an earlier postoperative pass flatus for rectal cancer patients (MD = -0.46, 95% CI = -0.66 to -0.27, P<0.001, I2 = 0%) and the more number of dissected lymph nodes for colon cancer patients (MD = 1.54, 95% CI = 0.05 to 3.03, P = 0.04, I2 = 69%) than the 2D group. There was no significant difference in postoperative overall complication (OR = 0.94, 95% CI = 0.67 to 1.31, P = 0.71, I2 = 0%) and anastomotic leakage (OR = 0.93, 95% CI = 0.48 to 1.80, P = 0.83, I2 = 0%) in the two groups, regardless of rectal cancer and colon surgery patients.
CONCLUSIONS: This meta-analysis demonstrates that 3D laparoscopy could reduce the amount of blood loss, accelerate postoperative pass flatus, and shorten the operation time and postoperative hospital stay over 2D for radical rectal cancer surgery, without obvious advantage for radical colon cancer surgery. Moreover, 3D laparoscopy increases the number of dissected lymph nodes for radical colon cancer surgery but may not be observed in rectal cancer surgery.
METHODS: A literature search was conducted through PubMed, Web of Science, and Embase from their inception to January 2024. Studies investigating different outcomes of colorectal surgery were included. Results are presented as odds ratios (ORs) or mean differences (MDs) with 95% confidence intervals (CIs). The protocol for this review has been registered on PROSPERO (CRD42024504902).
RESULTS: A total of 10 publications were retrieved in this article. The 3D group is associated with a significant improvement in intraoperative blood loss (MD = -8.04, 95% CI = -14.18 to -1.89, P = 0.01, I2 = 55%), operative time (MD = -17.33, 95% CI = -29.15 to -5.51, P = 0.004, I2 = 90%), and postoperative hospital stay (MD = -0.23, 95% CI = -0.43 to -0.04, P = 0.02, I2 = 48%) compared to that of patients treated in the 2D group, particularly for rectal cancer patients above three results (MD = -10.36, 95% CI = -15.00 to -5.73, P < 0.001, I2 = 0%), (MD = -18.85, 95% CI = -34.88 to -2.82, P = 0.02, I2 = 57%), and (MD = -0.93, 95% CI = -1.53 to -0.34, P = 0.002, I2 = 0%), respectively. There was no significant statistical difference in the time of pass flatus (MD = -0.14, 95% CI = -0.49 to 0.21, P = 0.44, I2 = 79%) and the number of dissected lymph nodes (MD = 0.36, 95% CI = -0.49 to 1.21, P = 0.41, I2 = 45%), but the 3D group had an earlier postoperative pass flatus for rectal cancer patients (MD = -0.46, 95% CI = -0.66 to -0.27, P<0.001, I2 = 0%) and the more number of dissected lymph nodes for colon cancer patients (MD = 1.54, 95% CI = 0.05 to 3.03, P = 0.04, I2 = 69%) than the 2D group. There was no significant difference in postoperative overall complication (OR = 0.94, 95% CI = 0.67 to 1.31, P = 0.71, I2 = 0%) and anastomotic leakage (OR = 0.93, 95% CI = 0.48 to 1.80, P = 0.83, I2 = 0%) in the two groups, regardless of rectal cancer and colon surgery patients.
CONCLUSIONS: This meta-analysis demonstrates that 3D laparoscopy could reduce the amount of blood loss, accelerate postoperative pass flatus, and shorten the operation time and postoperative hospital stay over 2D for radical rectal cancer surgery, without obvious advantage for radical colon cancer surgery. Moreover, 3D laparoscopy increases the number of dissected lymph nodes for radical colon cancer surgery but may not be observed in rectal cancer surgery.
摘要：
背景：本研究旨在评估2D腹腔镜与3D腹腔镜治疗结直肠癌的有效性和安全性。
方法：通过PubMed进行了文献检索，WebofScience,和Embase从成立到2024年1月。包括调查结直肠手术不同结局的研究。结果以比值比（OR）或平均差（MD）表示，具有95％置信区间（CI）。本次审查的协议已在PROSPERO（CRD42024504902）上注册。
结果：本文检索到10篇文献。3D组与术中出血量的显着改善相关（MD=-8.04，95％CI=-14.18至-1.89，P=0.01，I2=55％），手术时间(MD=-17.33,95%CI=-29.15~-5.51,P=0.004,I2=90%),和术后住院时间（MD=-0.23，95％CI=-0.43至-0.04，P=0.02，I2=48％）与2D组患者相比，特别是对于三个结果以上的直肠癌患者（MD=-10.36，95％CI=-15.00至-5.73，P<0.001，I2=0％），（MD=-18.85，95％CI=-34.88至-2.82，P=0.02，I2=57％），和（MD=-0.93，95％CI=-1.53至-0.34，P=0.002，I2=0％），分别。经肛门排气时间(MD=-0.14,95%CI=-0.49~0.21,P=0.44,I2=79%)和淋巴结清扫数(MD=0.36,95%CI=-0.49~1.21,P=0.41,I2=45%)差异无统计学意义,但是3D组的直肠癌患者术后肛门排气较早（MD=-0.46，95％CI=-0.66至-0.27，P<0.001，I2=0％），并且结肠癌患者的淋巴结清扫数量更多（MD=1.54，95％CI=0.05至3.03，P=0.04，I2=69％）。两组术后总并发症(OR=0.94,95%CI=0.67~1.31,P=0.71,I2=0%)和吻合口漏(OR=0.93,95%CI=0.48~1.80,P=0.83,I2=0%)比较,差异无统计学意义。无论直肠癌和结肠手术患者。
结论：这项荟萃分析表明，3D腹腔镜可以减少失血量，加速术后通过排气，并缩短直肠癌根治术的手术时间和术后住院时间，对于结肠癌根治术无明显优势。此外，3D腹腔镜检查可增加结肠癌根治术的淋巴结数量，但在直肠癌手术中可能未观察到。
方法：通过PubMed进行了文献检索，WebofScience,和Embase从成立到2024年1月。包括调查结直肠手术不同结局的研究。结果以比值比（OR）或平均差（MD）表示，具有95％置信区间（CI）。本次审查的协议已在PROSPERO（CRD42024504902）上注册。
结果：本文检索到10篇文献。3D组与术中出血量的显着改善相关（MD=-8.04，95％CI=-14.18至-1.89，P=0.01，I2=55％），手术时间(MD=-17.33,95%CI=-29.15~-5.51,P=0.004,I2=90%),和术后住院时间（MD=-0.23，95％CI=-0.43至-0.04，P=0.02，I2=48％）与2D组患者相比，特别是对于三个结果以上的直肠癌患者（MD=-10.36，95％CI=-15.00至-5.73，P<0.001，I2=0％），（MD=-18.85，95％CI=-34.88至-2.82，P=0.02，I2=57％），和（MD=-0.93，95％CI=-1.53至-0.34，P=0.002，I2=0％），分别。经肛门排气时间(MD=-0.14,95%CI=-0.49~0.21,P=0.44,I2=79%)和淋巴结清扫数(MD=0.36,95%CI=-0.49~1.21,P=0.41,I2=45%)差异无统计学意义,但是3D组的直肠癌患者术后肛门排气较早（MD=-0.46，95％CI=-0.66至-0.27，P<0.001，I2=0％），并且结肠癌患者的淋巴结清扫数量更多（MD=1.54，95％CI=0.05至3.03，P=0.04，I2=69％）。两组术后总并发症(OR=0.94,95%CI=0.67~1.31,P=0.71,I2=0%)和吻合口漏(OR=0.93,95%CI=0.48~1.80,P=0.83,I2=0%)比较,差异无统计学意义。无论直肠癌和结肠手术患者。
结论：这项荟萃分析表明，3D腹腔镜可以减少失血量，加速术后通过排气，并缩短直肠癌根治术的手术时间和术后住院时间，对于结肠癌根治术无明显优势。此外，3D腹腔镜检查可增加结肠癌根治术的淋巴结数量，但在直肠癌手术中可能未观察到。
