Comparison of Surgical Outcomes and Safety between Three-and Two-Dimensional Laparoscopy in Colorectal Cancer Surgery

3D與2D腹腔鏡大腸直腸癌手術於安全性與預後之比較

李明璋(Ming-Chang Li) ； 趙育慧(Yuh-Huey Chao) ； 邱艷芬(Yann-Fen C. Chao) ； 余盈輝(Ying-Hui Yu) ； 柴康莊(Kang-Chuang Chai)

《中華民國大腸直腸外科醫學會雜誌》 31卷1期 (2020/03) Pp. 41-48

https://doi.org/10.6312/SCRSTW.202003_31(1).10823

摘要

Background. 3D HD (high definition) image system for laparoscopic surgery had been introduced to Taiwan for years, this study was aimed to evaluate the safety, efficacy and short-term outcome in patients received colorectal cancer surgery via this assisted medical system in our hospital. Methods. From January 2014 to December 2018, 275 patients underwent laparoscopic colorectal surgeries through 3D HD (n=111) and 2D HD (n=164) real-time image system. Surgical safety, efficacy and short outcome were evaluated. Results. The 3D HD laparoscopic surgery group has significantly less operative time (206 vs. 242 minutes, p=0.0004), less length of postoperative hospital stay (7.8 vs. 11 days, p=0.038), lower major morbidity rate (5.6% vs. 14.6%, p=0.016) and lower leakage rate (2.8% vs. 9.1%, p=0.034). The groups had similar tumor resection margin (5.0 vs. 4.2 cm, p=0.38) and numbers of lymph nodes harvested (19.0 vs. 19.6, p=0.57). Though there were no significant differences in perioperative blood loss (94 vs. 115 c.c., p=0.355), conversion (2.8% vs. 4.3%, p=0.496), and 30-day mortality (0.9% vs. 3.6%, p=0.154), relative risk reductions were observed. Conclusions. The 3D imaging system is a safe and feasible equipment, and the short outcomes are equivalent and better than 2D imaging systems. It may be beneficial due to less operative time, less major morbidity rate and less leakage rate.

關鍵字

3-D imaging ； Colorectal cancer ； Colorectal surgery ； Laparoscopy

並列摘要

目的：腹腔鏡大腸直腸手術近年來在台灣已被廣泛使用，而3D立體腹腔鏡技術亦日漸普及。本研究報告此技術於本院使用之安全性與預後評估。方法：本研究回溯性收集自2014年1月至2018年12月，共275位接受3D（111位）及2D（164位）腹腔鏡大腸直腸切除術之病患，進行評估並比較安全性、效果及短期預後之差異。結果：兩者病患基本資料無差異。3D立體腹腔鏡手術之手術時間較短（206分鐘vs. 242分鐘），術後住院日數亦較短（7.8日vs. 11日）。而術後併發症率（5.6% vs. 14.6%），及接口滲漏率（2.8% vs. 9.1%）亦明顯較低。但3D及2D腹腔鏡手術病患，兩者之間無腫瘤大小、淋巴結廓清數量之差異。而在短期預後方面，兩者之術後出血量，轉換開腹率，及術後30日死亡率均無統計學上之差異。結論：3D立體腹腔鏡手術為一種安全及可接受的手術技術。

並列關鍵字

3D立體影像 ； 大腸直腸癌 ； 大腸直腸手術 ； 腹腔鏡微創手術

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