Comparative Study of the Short-Term Outcomes and Long-Term Outcomes using Total 3D and 2D Laparoscopic Distal Gastrectomy with Delta-Shaped Anastomosis for Gastric Cancer

Three-dimensional (3D) laparoscopy has advantages over two-dimensional (2D) in gastric cancer (GC) surgery, but there is still no comparative study of 3D versus 2D for delta-shaped anastomosis (DA). The objective of this study was to investigate the short-term and long-term efficacy and safety of 3D laparoscopy in distal gastrectomy with DA. We retrospectively analyzed the clinical data of 134 patients treated with 3D (n = 70) and 2D (n = 64) laparoscopic D2 lymphadenectomy for distal GC at the Shaoxing People’s Hospital from 07/2016 to 03/2022. The effects on baseline, pathology, perioperative data (operative time, anastomosis time, operation blood loss, diameter, splenic injury, number of lymph nodes, time to first flatus, time to liquid diet, postoperative hospital days, and inpatient costs), complications, and 5-year follow-up were analyzed. The difference between the baseline (general information and postoperative pathology) of the two groups was not statistically significant (P > 0.05). The 3D group was associated with a shorter anastomosis time (15.76 min vs 17.89 min, P < 0.0001) but a similar operative time (175.70 vs 182.80 min, P = 0.1664). Shorter time to liquid diet (2.09 vs 2.47 days, P < 0.0001) and postoperative hospital days (7.56 vs 8.75 days, P < 0.0001) of 3D group were observed. The complications, 5-year follow-up overall survival and disease-free survival rates between the groups were not statistically significant. 3D laparoscopy is safe and effective with a faster procedure and recovery time.