Clinical Analysis Of Robot-assisted Laparoscopic And Traditional Laparoscopic Radical Cystectomy

Objective:To compare and analyze the difference of curative effect between robot-assisted laparoscopic and traditional laparoscopic radical cystectomy,and to explore the safety and feasibility of robot-assisted laparoscopic radical cystectomy.Methods:The clinical data of 137 patients undergoing radical cystectomy in our hospital from January 2015 to March 2018 were retrospectively analyzed.According to different surgical methods,they were divided into the robotic group and the traditional laparoscopic group,with 61 cases and 76 cases respectively.Compare the differences of two groups in gender,age,BMI,previous abdominal surgery,clinical stage,grade of ASA,urinary diversion way,operation time,intraoperative blood loss,intraoperative blood transfusion,postoperative ventilation time,pelvic drainage tube extubation time,postoperative hospital stay,postoperative pathological staging,number of lymph nodes cleaned,positive rate of lymph nodes,positive margin,postoperative complications,grade of complications,etc.The above data were processed by SPSS 22.0 software,two independent sample t-tests were selected to compare the measurement data,and chi-square test or Fisher exact probability method were selected for comparison of counting data.Results:A total of 137 patients were successfully implemented the surgical plan,and none of them were transferred to open surgery.There was no statistically significant difference in the general data between the two groups(P>0.05),which was comparable.There were statistically significant differences in intraoperative blood loss(316.07±198.31mL VS 392.76±221.77mL),postoperative ventilation time(3.11± 1.85d VS 4.07±2.30d),postoperative pelvic drainage tube extubation time(8.30±4.55d VS 10.28±4.03d),postoperative hospital stay(11.98±4.15d VS 13.63±5.14d),and positive rate of lymph nodes(32.8%VS 17.1%)between robotic surgery and conventional laparoscopic surgery(P<0.05).There were no statistically significant differences in operation time(362.79±81.24min VS 346.68±83.08min),intraoperative blood transfusion(4.9%VS 7.9%),number of lymph nodes cleaned(18.16±8.61 VS 16.86±8.25),positive margin(1.6%VS 3.9%)and postoperative complications(9.8%VS 15.8%).Conclusion:1.Both surgical methods are feasible and safe,and have achieved good clinical efficacy in the treatment of patients with bladder cancer.2.Compared with laparoscopic surgery,robotic surgery has advantages in intraoperative blood loss,postoperative ventilation time,postoperative pelvic drainage tube extubation time,postoperative hospital stay,positive rate of lymph nodes and so on.