Comparison of Short-Term Outcomes Between 3D and 2D Imaging Laparoscopic Colectomy with D3 Lymphadenectomy for Colon Cancer

Background: Three-dimensional (3D) imaging for laparoscopy was introduced to overcome the limitations of conventional two-dimensional (2D) imaging that lacked depth perception and spatial orientation. This study aimed to evaluate the effect of 3D imaging in laparoscopic colectomy with D3 lymphadenectomy for colon cancer. Methods: From February 2014 to October 2016, the prospective database of 278 consecutive patients with colon cancer was analyzed retrospectively; these patients underwent laparoscopic surgery with 2D (n=111) and 3D (n=167) imaging, with curative intent. Results: No difference was found in sex, body mass index, history of abdominal surgery, and American Society of Anesthesiologists grade between the 3D and 2D groups. The estimated blood loss was less in the 3D group than in the 2D group (50mL [30-100mL] versus 100mL [50-100mL], P<.001). The number of resected lymph nodes was higher in the 3D group (n=47 [37.5-60] versus 41 [32-51.5], P=.001). However, a difference in operative time was not observed in both groups (150 minutes [125-175 minutes] versus 155 minutes [135-177.5 minutes], P=.186). Postoperative morbidity was similar in both groups (7.8% versus 8.1%, P=1.000). Time to pass first flatus (3 days [2-4 days] versus 3 days [3-4 days], P=.746) and postoperative hospital stay (6 days [6-8 days] versus 6 days [6-7 days], P=.087) were also similar. Conclusions: This study shows that laparoscopic colectomy with D3 lymphadenectomy for colon cancer using 3D laparoscopic systems appears to be beneficial, with less blood loss, which should be addressed in prospective studies.