Comparison Of Short-term Outcomes Of Radical Resection Operation Between Robotic And Laparoscopic-assisted For Middle And Low Rectal Cancer

Objectives:To investigate the short term outcomes of robotic-assisted and laparoscopic radical resection for middle and low rectal.2 、 Assess the safety and feasibility of robotic assisted radical resection for middle and low rectal cancer surgery.Methods:The clinical data for 200 rectal cancer patients were selected from the First Affiliated Hospital of Nanchang University from January 2016 to December2017,and select 120 radical resection in laparoscopic-assisted rectal cancer for the same team were analyzed retrospectively.The distance between the lower edge of the tumor in all patients was less than or equal to 12 cm.The intraoperative and postoperative conditions were compared between the two groups of patients,and collected the data.Results:All surgeries were performed successfully,there were no conversions during operation.Compared with laparoscopic group,the robotic group had less intraoperative blood loss [(69.3±38.6)mL vs.(137.6±68.2),P<0.01] and shortened mean operative time [(116.2±19.4)min vs.(146.6min ±30.5 min),P<0.01].The recovery time and diet recovery time of the gastrointestinal function were significantly shorter in the robot group than in the laparoscopic group and postoperative extubation time was earlier than the laparoscopic group[(4.3±1.2)d vs.(4.9 ±1.6)d,P<0.05].The function of urination restores quickly.The anal sphincter preservation rate of rectal cance was significantly higher in the robotic group than in the laparoscopic group[84.5%(169/200)vs 70.8%(85/120),P<0.05,]and the anal sphincter preservation rate of low rectal cance was significantly higher in the robotic group than in the laparoscopic group [64.0%(55/86)vs 31.4%(16/51,P<0.05].Butthe hospital cost was significantly higher than the laparoscopic group(55.0±14.2vs.43.0±21.3 thousands yuan,P<0.05).the surgery cost was significantly higher than the laparoscopic group[(32.0±8.1)vs.(18.2±6.2)thousands yuan,P<0.05)].No statistically significant differences in the cost of non-surgical.[(26.4±10.1)vs.(25.3±13.2)thousands yuan,P>0.05].Pathological examinations showed that the two groups reached the radical operation of rectal cancer operation standard requirements,including cleaning of the lymph nodes,number of resected bowel resection margin tissue of cancer tissue.Two groups of patients circumferential resection margin were negative,all the robot operation excision of the mesorectum were,then three cases of laparoscopic operation of mesorectum integrity was destroyed.There was no significant difference in the length of the specimen,the tumor size,the number of lymph nodes harvested,inferior margin of tumor margin,length of hospital stay,postoperative morbidity between the laparoscopic group and robotic group(P>0.05).Conclusion:The robotic rectal cancer surgery can achieve a similar radical therapeutic effect to laparoscopic surgery,fully meet the tumor treatment principle.Robotic surgery system is safe and feasible for the treatment of patients with middle and lower rectal cancer.The short-term outcomes of the robotic proctectomy are better than those of the laparoscopic proctectomy in terms of trauma,intraoperative bleeding,operation time,recovery of bowel and urinary function,higher anal preserving rate,the prospect of application is wider.