Comparison Of The Clinical Efficacy Of Robot-assisted,Laparoscopic And Open Surgery Of Radical Cystectomy

Object:To compare the clinical efficacy of robotic assisted radical cystectomy and laparoscopic radical cystectomy and open radical cystectomy.Methods:Retrospectively analyze 395 cases with complete clinical data of patients with bladder cancer from January 2014 to September 2016 underwent radical cystectomy in our hospital.Among them,there were 327 males and 68 females with an average age of 66 years old.According to the different surgical methods,cases were divided into 3 groups: open radical cystectomy(ORC group)120 cases,laparoscopic radical cystectomy(LRC group)139 cases,robot-assisted radical cystectomy(RARC group)136 cases.The intraoperative conditions,postoperative recovery and complications of the three methods were compared and analyzed.Results:There was no significant statistical difference in preoperative clinical data between the 3 groups(P>0.05),The operation time of ORC,LRC,RARC 3 group was prolonged gradually(267.3±92.3min,304.8±108.9min,364.6±86.4min,P<0.05),Intraoperative hemorrhage in 3 groups decreased gradually(473.3±272.5ml,373.0±213.7ml,205.6±137.8ml),The postoperative time to exhaust of RARC was significantly shorter than that of ORC and LRC(3.6±1.8 d,3.5±1.2 d,2.2±1.7 d,P<0.05),Postoperative ileus occurred in 3 groups had no significant statistical difference(P=0.67),Length in stay RARC was significantly shorter than that of ORC and LRC(18.3±11.8 d,16.3±7.4 d,14.2±7.2 d,P<0.05),the incidence of hydronephrosis in RARC group was significantly lower than that in LRC group 6 months postoperation(ORC)(15.0%,5%,3.7%,P<0.05)?Median follow-up time was 10 months.Positive surgical margin in RARC group was significantly lower than that in LRC group and ORC group(5.0%,4.3%,0),There was no significant statistical difference between the 3 groups in the number of lymph node dissection and recurrence.Conclusion:Compared with ORC,LRC has a longer operation time,less bleeding,faster postoperative recovery,less complications,RARC has a longer operation time than LRC,but further reduce intraoperative bleeding,accelerate postoperative recovery and reduce the incidence of complications.The 3 methods are similar in oncology outcomes,but need further study.