Effect of flexible 3D laparoscopic surgery on rectal cancer after neoadjuvant chemoradiotherapy

Objective To investigate the clinical effects and advantages of flexible 3D laparoscopic surgery on rectal cancer after neoadjuvant chemoradiotherapy (nCRT). Methods The data of 152 patients who received laparoscopic rectal cancer resection after nCRT excluding the cases of high rectal cancer, cardiac and pulmonary dysfunction were analyzed from January 2015 to January 2016 in the Department of Colorectal Surgery of Liaoning Cancer Hospital. The distances from the annal edge to the inferior tumor margin were within 8 cm in these patients. Among these patients, 76 cases received the 3D laparoscopic surgery after nCRT (3D-nCRT), and 76 cases undergone the 2D laparoscopic surgery after nCRT (2D-nCRT). Results Between two groups, the number of lymph node harvest (14.8±2.1 vs. 14.3±1.7), positive rate of the distal margin [1.3% (1/76) vs. 2.6% (2/76)], reserving anus rate [92.1% (70/76) vs. 81.2% (67/76)], local recurrence rate [1.3% (1/76) vs. 3.9% (3/76)] and anastomotic leakage rate [2.6% (2/76) vs. 3.9% (3/76)] had no statistical differences (all P > 0.05), while the operative time [(125.3±10.2) min vs. (136.6±12.0) min], intraoperative bleeding [(54.1±23.2) ml vs. (61.9±19.5) ml], anus exhaust time [(43.5±5.0) h vs. (45.4±5.6) h] and positive rate of circumferential resection margin (CRM) [1.3% (1/76) vs. 9.2% (7/76)] had statistical differences (all P < 0.05). Conclusion Flexible 3D laparoscopic surgery on rectal cancer after nCRT can shorten operative time, reduce intraoperative bleeding, alleviate the influence of intestinal peristalsis function,and improve operative quality. Key words: 3D Laparoscopy; Rectal neoplasms; Laparoscopic surgery; Neoadjuvant chemoradiotherapy; Surgical procedures, minimally invasive