Functional and early oncological results in 2D vs 3D laparoscopic prostatectomy

Aim . To evaluate functional and early oncologic results with 2D and 3D laparoscopic prostatectomy in patients with localized prostate cancer. Materials and methods. In 2016 to 2017, 124 laparoscopic radical prostatectomies were performed for localized prostate cancer, 71 using 2D-HD and 53 using 3D-HD laparoscopic systems (Karl Storz). Data on total operative time, time required for prostatectomy and for anastomosis, estimated blood loss, intraoperative and early postoperative complications (Clavien-Dindo grade), early functional results, surgical margins, upgrading of clinical stage, and frequency of biochemical recurrence were recorded. Results. The total operative was significantly higher in the 2D than in the 3D group (152 min [range 100–192 min] vs 126 min [90–154 min]), (p < 0.05). The shorter time in the 3D group was achieved by a decrease in the anastomosis time (38 ± 4 min vs 26 ± 4 min, p < 0.05). Significant blood loss was significantly greater in the 2D group (240 ± 80 ml vs 190 ± 70 ml, p < 0.05). The two groups did not differ significantly in terms of the incidence and severity of postoperative complications. Conclusion. Compared with traditional 2D devices, using stereoscopic 3D laparoscopic devices for prostatectomy reduces total operative time, particularly during the reconstructive stage, as well as the volume of intraoperative blood loss. Additional prospective, randomized trials and longer postoperative follow-up are needed to confirm these findings.