Comparison Of Clinical Efficacy Of Robot-assisted And Laparoscopic Radical Prostatectomy

Objective:A comparison of the effectiveness and security of robot-assisted radical prostatectomy（RALP）and the classic laparoscopic radical prostatectomy（LRP）is made,which can be used as a reference for the selection of clinical treatment.Methods:A retrospective analysis of clinical data from those diagnosed with prostate cancer who had undergone a radical prostatectomy between January 2019 and June2022 was conducted.A total of 121 patient data were collected in this study.This research divided 86 patients into two groups based on the operative methods,43 in the RALP group and 43 in the LRP group,based on inclusion and exclusion criteria.The advantages and disadvantages of the two methods were evaluated by comparing and analyzing the differences in general preoperative data,including age,BMI,prostate volume,preoperative t PSA,biopsy Gleason score,clinical stage,basic disease,intraoperative bleeding loss,conversion rate,operation time,blood transfusion or not,postoperative complications,postoperative landing time,postoperative exhaust time,postoperative pathological stage,positive tumor margin,drainage tube extraction time,etc.The influencing factors of positive surgical margins were also analyzed.Results:The average age,BMI,prostate volume,preoperative t PSA,clinical stage,biopsy Gleason score,and underlying disease of the two groups were analyzed.No noteworthy divergence was discernible between the two assemblages in general information（P>0.05）.Surgery was successfully completed in both groups,and no cases were converted to open surgery.The time of operation of patients in the RALP group[172（147,205）min]was shorter than that in the LRP group[194（165,215）min]（P<0.05）,with a statistically significant difference.There were 17 cases of lymph node dissection in the RALP group and 12 cases of lymph node dissection in the LRP group.The median postoperative exhaust time[2（2,3）d]in the RALP group was shorter than LRP group[3（2,3）d],and the median postoperative lower ground time[2（2,3）d]in the RALP group was shorter than that in the LRP group[3（2,3）d].The median postoperative hospitalization time[5（4,6）]days in the RALP group was shorter than[6（5,8）]days in the LRP group.A statistically significant distinction was observed between the two groups;the RALP group（61523.16±6111.289）had a significantly greater hospitalization expense than the LRP group（41276.19±8402.449）.In terms of postoperative complications,Clavien-Dindo complications of more than grade I were collected.There were 2 cases（4.7%）in the RALP group,all of which were grade II complications,and 9 cases（20.9%）in the LRP group,of which 7 cases were grade II complications and 2 cases were grade III complications.One case was postoperative urination,and a double kidney puncture fistula was given;the other was a rectal fistula,and a colostomy was performed.A statistically significant distinction between the two groups was observed in the Clavien-Dindo grade I complications.In the RALP group,the rate of surgical margin was 67.4%positive,while the LRP group had 55.8%positive;the postoperative pathological stage of the two groups was between p T₂-p T_3b.Urinary leakage occurred in 6 cases（14%）in the RALP group and 3 cases（7%）in the LRP group.No statistical disparity was observed between the two sets in terms of blood loss and transfusion rate,postoperative pathological stage,surgical margin,and urine leakage（P>0.05）.Conclusion:There is no statistical difference between the two groups in terms of blood loss,blood transfusion rate,postoperative pathological stage,surgical margin,urine leakage,etc.Patients in the RALP cohort possess a number of benefits,such as operation duration,postoperative exhaust duration,postoperative landing time,and postoperative hospital stay,and postoperative complications Clavien-Dindo I above,while the patients in the LRP group have fewer hospital expenses than the patients in the RALP group.Therefore,RALP can be used as a safer and more effective treatment for localized prostate cancer.