A Comparative Study Of Robotic-assisted Lymphadenectomy Versus Conventional Laparoscopic Lymphadenectomy

Objective: Robotic surgery system is the most advanced operation platform at present.It needs more data to confirm its advantages and disadvantages in the operation scope and postoperative recovery of clinical patients.The aim of the article is to analyze the difference between Davinci robotic surgery system and conventional laparoscopic surgery in the scope of lymphadenectomy and the postoperative complications related to lymphadenectomy in order to provide a reference for clinical treatment and provide a more objective basis for doctors and patients to choose the operative method.Methods: A total of 237 cases of cervical cancer undergoing radical hysterectomy of cervical cancer in First Affiliated Hospital of Chongqing Medical University from February 2016 to February2018 were collected,including 153 cases in group LRH(conventional laparoscopic radical hysterectomy)and 84 cases in group RRH(robot-assisted radical hysterectomy).In the stage of IA2-IIA radical hysterectomy of cervical cancer,the number of lymph nodes obtained,lymph node metastasis,the incidence of intraoperative complications,postoperative recovery and the incidence of postoperative complications were compared between the two groups.The possible influencing factors and correlation of lymphadenectomy related complications were analyzed.Results: There were significant difference between the two groups in catheter retention time(RRH: 14(3)d,LRH: 14(0)d,P<0.05),postoperative drainage volume(LRH: 110(247.5)ml,RRH: 191(368)ml,P<0.05)and intraoperative bleeding volume(RRH: 80(50)ml,LRH: 100(100)ml,P<0.05).There was no significant difference between the two groups in the number of lymph nodes obtained,lymph node metastasis,operation time,anal exhaust time,postoperative hospital days,postoperative pelvic drainage tube retention time,intraoperative and postoperative complications(P> 0.05).There was no significant correlation between the number of lymph nodes obtained and preoperative albumin level,preoperative hemoglobin level,age or postoperative drainage(P>0.05);and no significant correlation between the number of lymph nodes obtained and lymph node metastasis or perineum and lower extremity edema(P>0.05).Besides,there was no significant correlation between postoperative drainage and stage(P>0.05);however,there was a positive correlation between postoperative pelvic drainage tube retention time and postoperative drainage volume(P<0.001).Conclusions: Davinci robot surgery system is a relatively safe,feasible and effective operation method.In Radical hysterectomy of cervical cancer,the incidence of complicationsrelated to Lymphadenectomy in the RRH group is lower than that in the LRH group,but there is no significant difference in statistics;however,the intraoperative bleeding volume in the RRH is significantly less(P<0.05)than that in LRH,and the time of urinary tube retention is significantly shorter than that in LRH(P<0.05),which can be used as a safe and reliable operation method.