| Objective:By comparing the perioperative clinical data of da Vinci Xi surgical robot and traditional laparoscopic right hemicolectomy,this paper discusses the safety,feasibility and short-term clinical prognosis of right hemicolectomy on Xi platform.Methods:Retrospective analysis was conducted on 55 patients with colon cancer who underwent right hemicolectomy using da Vinci Xi robot or traditional laparoscope in the Department of gastrointestinal surgery,the Second Hospital of Shandong University from January 2020 to January 2022.Patients were strictly screened according to certain inclusion and exclusion criteria.They were divided into robot surgery group(R-RC group)and laparoscopic surgery group(L-RC group).To collect and evaluate the relevant data of preoperative,intraoperative,postoperative and histopathology in R-RC group and L-RC group,and compare the differences in short-term clinical prognosis between two groups.Results:A total of 55 patients were included in this paper,including 25 in R-RC group and 30 in L-RC group.There were no significant differences between the two groups in gender,age.ASA grade,BMI.previous abdominal surgery history,tumor location,tumor stage and preoperative hematological indexes(P>0.05).In terms of intraoperative related indicators,the R-RC group had longer operation time(184.76±21.96 min vs 166.63±26.32 min)and less blood loss(62.28±24.88 mL vs 91.47±26.55 mL),with statistically significant differences(P<0.05).There were no significant differences in the time of endoscopic operation,the length of auxiliary incision and the number of intraoperative blood transfusion between the two groups(P>0.05).In addition,the average docking time of the robotic surgical system in the R-RC group was 14.11±4.03 min.In terms of postoperative results,the first postoperative exhaust time(49.44±5.86 h vs 52.60±5.40 h)and the first fluid intake time(66.60±7.06 h vs 71.13±8.89 h)in the R-RC group were earlier than those in the L-RC group,with statistically significant differences(P<0.05).There were no significant differences in postoperative VAS score,time to get out of bed for the first time,postoperative drainage tube drainage time,postoperative hospital stay and postoperative hematology related indicators(P>0.05).There was no statistical difference in the incidence of total postoperative complications between the two groups(16%vs 20%,P>0.05).The 4 complications in the R-RC group were all minor complications(Clavien-Dindo Ⅰ-Ⅱ),including 1 intestinal obstruction,1 chylous fistula,and 2 pulmonary infections.In the L-RC group,there were 6 cases of postoperative complications,including 4 cases of minor complications(1 case of intestinal obstruction,bleeding,pulmonary infection,and 1 case of poor wound healing),and 2 cases of moderate to severe complications(1 case of postoperative gastroparesis and 1 case of anastomotic leakage).In terms of pathological data,the number of lymph nodes obtained in the R-RC group was higher than that in the L-RC group(31.76±8.65 vs 25.23±6.12),the difference was statistically significant(P<0.05).There were no significant differences in pathological type,pathological stage,positive number of lymph nodes,specimen length and maximum tumor diameter(P>0.05).Conclusion:It is safe and feasible to perform right hemicolectomy on the da Vinci Xi robot platform.Compared with traditional laparoscopic surgery,it has the characteristics of less intraoperative bleeding,more lymph node obtained and faster postoperative recovery. |
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