How Technology Can Impact Surgeon Performance: A Randomized Trial Comparing 3-Dimensional versus 2-Dimensional Laparoscopy in Gynecology Oncology

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• 作者：Francesco Fanfani ; MD^a ; ^{francesco.fanfani@unich.it" class="auth_mail" title="E-mail the corresponding author} ; Cristiano Rossitto ; MD^b ; Stefano Restaino ; MD^c ; Alfredo Ercoli ; MD^d ; Vito Chiantera ; MD^e ; Giorgia Monterossi ; MD^b ; Giulia Barbati ; MD^f ; Giovanni Scambia ; MD^b
• 关键词：Cervical cancer ; Endometrial cancer ; Three-dimensional laparoscopic
• 刊名：Journal of Minimally Invasive Gynecology
• 出版年：2016
• 出版时间：July-August 2016
• 年：2016
• 卷：23
• 期：5
• 页码：810-817
• 全文大小：466 K

文摘

This randomized clinical trial (Canadian Task Force classification I) aimed to compare 2-dimension (2-D) versus 3-dimensional (3-D) laparoscopic hysterectomy and pelvic lymphadenectomy in endometrial and cervical cancer patients. Between December 2014 and March 2015, 90 patients were enrolled: 29 (32.2%) with early or locally advanced cervical cancer after neoadjuvant treatment and 61 (67.8%) with early-stage endometrial cancer. Patients were randomly assigned to undergo 2-D (Group A, n = 48 [53.3%]) or 3-D (Group B, n = 42 [46.7%)]) laparoscopy. Baseline characteristics were superimposable in the 2 groups. Median operative time was similar in the 2 groups. Median estimated blood loss during lymphadenectomy was significantly lower in Group B than in Group A (38 mL [range, 0–450] vs 65 mL [range, 0–200]; p = .033). In cervical cancer patients operative time of pelvic lymphadenectomy performed by “novice” surgeons (those with <10 procedures performed) was statistically significantly lower in Group B (p = .047). No differences in perioperative outcomes and postoperative complications were observed between the 2 groups. The 2-D and 3-D systems can be used safely in laparoscopic hysterectomy. However, the 3-D system could provide key benefits to intraoperative techniques and postoperative outcomes in reducing operative time for “expert” surgeons and in enhancing surgical precision for “novice” surgeons.