3D腹腔镜与2D腹腔镜在宫颈癌根治术中的临床比较研究

目的:比较3D腹腔镜与2D腹腔镜宫颈癌根治术的临床疗效。方法:回顾分析102例腹腔镜下宫颈癌根治术患者的临床资料,其中3D腹腔镜组55例,2D腹腔镜组47例,对比分析两组手术时间、术中出血量、淋巴结切除数量、术后并发症(尿潴留、输尿管损伤、闭孔神经损伤、血栓形成、淋巴囊肿等)的差异。结果:102例手术均获成功,两组手术时间(203±30.88)min vs.(223±22.63)min]、术中出血量(119±46.15)ml vs.(156±71.27)ml]、术后并发症发生率(9.09%vs.29.79%)、切除淋巴结数量(25.0±5.77)vs.(23.0±6.99)]差异有统计学意义(P0.05);切除宫旁宽度(3.81±0.39)cm vs.(3.75±0.38)cm]、切除阴道长度(3.59±0.48)cm vs.(3.67±0.39)cm]差异无统计学意义(P0.05)。结论:与2D腹腔镜相比,3D腹腔镜在空间定位及深度感觉方面具有明显优势,解剖层次更加清晰,具有手术时间短、术中出血量少、术后并发症少等优点,能切除更多淋巴结,手术标本切除更彻底,值得临床推广。

Comparative study of 3D versus 2D laparoscopic radical hysterectomy for cervical cancer

Objective:To compare the clinical effect of 3D versus 2D laparoscopic radical hysterectomy for cervical cancer.Methods:In this single institutional study,102 patients with cervical cancer underwent surgical treatment in Tianjin Central Hospital of Gynecology Obstetrics,55 patients underwent 3D laparoscopic radical hysterectomy,47 patients of control group underwent 2D laparoscopic radical hysterectomy.The operative time,intraoperative blood loss,number of excised lymph node,postoperative complications (urinary retention,ureteral injury,obturator nerve damage,thrombosis,lymphocele and so on) of two groups were comparatively analyzed.Results:All the 102 operations were successful.There were significant differences in operating time (203 ± 30.88) min vs.(223 ± 22.63) min],blood loss (119 ± 46.15) ml vs.(156 ± 71.27) ml],postoperative complications (9.09％ vs.29.79％) and the number of resected lymph nodes (25.0 ±5.77) vs.(23.0 ±6.99)] of the 3D group and 2D group (P ＜0.05),there was no statistically significant difference in the resected parametrial width (3.81 ± 0.39) cm vs.(3.75 ± 0.38) cm] and vaginal length (3.59 ± 0.48) cm vs.(3.67 ± 0.39) cm] (P ＞ 0.05).Conclusions:Compared with conventional 2D laparoscopy,3D laparoscopic system provides stereoscopic vision,which guarantees a clearer view and more accurate dissection.3 D visualization may reduce the operating time,blood loss and postoperative complications.Furthermore,it can increase harvested lymph nodes,thus surgical specimens can be removed more thoroughly.3D laparoscopic technology is worth clinical application.