Effectiveness Of Robot-assisted Laparoscopic Versus Traditional Laparoscopic Surgery For The Treatment Of Retroperitoneal Paragangliomas

Objective:To compare the effectiveness of robot-assisted laparoscopic surgery(RALS)and traditional laparoscopic surgery(TLS)in the treatment of retroperitoneal paragangliomas(PGL),and construe defect of robot-assisted laparoscopic surgery and evaluate the safety and feasibility of RALS.Methods This retrospective cohort study analyzed 23 patients who underwent surgery from January 2009 to January 2016,including 6 cases treated by RALS and another 17 cases treated by TLS.The perioperative and follow-up data of all patients were recorded and analyzed statistically.Results Compared with TLS,RALS indicated a significant superiority with less blood loss[(227.5±158.4)vs.(422.5±623.0)ml,P=0.045]and fluctuations of intraoperative blood pressure[(56.7±15.0)vs.(91.8±34.5)mmHg,P=0.011].No statistical difference was discovered in operative time[(150.0±73.5)vs.(143.5±125.8)min P=0.882],utilization of Esmolol[(1/5)vs.(10/7)(yes/no),P=0.155],blood transfusion[(1/5)vs.(3/14)(yes/no),P=1.000],postoperative complications[(150.0 ± 73.5)vs.(143.5 ± 125.8)min,P=0.882],time to oral-intake[(3.4 ± 2.7)vs.(3.4 ± 2.7)min,P=0.939],time to off-bed activity[(2.7 ±2.9)vs.(2.2±0.8)min,P=0.541],length of catheter-indwelling[(5.2±4.8)vs.(3.5±0.6)min,P=0.509]and hospital stay[(8.7 ± 8.6)vs.(6.2 ± 1.5)min,P=0.887].One patient undergoing TLS recurred in postoperative follow-up,while no recurrence after RALS.Conclusions RALS is a safe and effective micro-invasive operation in the treatment of retroperitoneal PGL.But compare with traditional surgery,high cost of treatment is noteworthiness,meanwhile,Large-scale randomized controlled trials are required to testify our conclusion.