D’Urbano C*, Pennacchi L, Cornelli A, Marazzi F and Viti M
Department of Surgery, Garbagnate Milanese Hospital, ItalyFulltext PDF
Background: Three-Dimensional (3D) vision systems have been applied recently in the field of general surgery. Here we aim to assess the feasibility and accuracy of D2 lymphadenectomy during subtotal gastrectomy performed in 3D laparoscopic approach in comparison with standard laparoscopy (2D). Materials and Methods: This retrospective observational study compared operative measures and post-operative outcomes between laparoscopic 3D and laparoscopic 2D subtotal gastrectomy with D2 lymphadenectomy. From 2014 to 2016, retrospective review of 48 patients with gastric cancer located in the lower third of the stomach treated with laparoscopic subtotal gastrectomy with D2 lymphadenectomy; 23 of them with 3D laparoscopic approach and 25 with standard laparoscopic approach (2D). Operative time, blood loss, harvested lymph nodes and post-operative hospital stay were compared. Results: 48 subtotal R0 gastrectomy with D2 lymphadenectomy were performed. These patients were divided into two groups (3D and 2D). The mean number of dissected lymph nodes was 35.5 ± 11.1 in 3D group and 23.5 ± 5.3 in 2D group. Perioperative mortality and morbidity rates were 2.1% and 17% in 3D group and 0% and 16% in 2D group. The conversion rate was 8.7% in 3D group and 24% in 2D group. Hospital stay was similar in the two groups. The operative time and blood loss were lower in 3D group in the absence of a statistically significant difference. Conclusion: 3D Laparoscopic D2 lymphadenectomy during subtotal gastrectomy for early and advanced gastric cancer is feasible and oncological effective with a statistically significant evidence of a greater number of retrieved lymph nodes (p<0.05). In our experience it is therefore demonstrated that there is a higher accuracy of D2 lymphadenectomy performed with 3D approach.
Gastrectomy; Lymphadenectomy; Laparoscopic; Early gastric cancer (EGC)
D’Urbano C, Pennacchi L, Cornelli A, Marazzi F, Viti M. Accuracy of D2 Lymphadenectomy in Laparoscopic Subtotal Gastrectomy 3D vs. 2D: Preliminary Results. Ann Clin Surg. 2020; 1(3): 1012.