A Clinical Study Of Davinci Robotic Anterior Resection For Rectal Cancer

Objective:To analyze the clinical efficacy of anterior resection of rectal cancer using da Vinci robotic surgical system compared with laparoscopy,and to analyze the clinical efficacy and feature of robotic anterior resection of rectal cancer using monopolar electro-surgical scissors and harmonic scalpel.Methods:A retrospective study was done on 46 patients with rectal cancer receiving da Vinci robotic assisted anterior resection comparing 69 patients of laparoscopic assisted anterior resection from June 2015 to January 2018.Perioperative results were collected from two groups.The clinical and pathological characteristics of two groups were similar.The intraoperative and postoperative conditions between the two groups were compared.Then divided the 46 robotic cases by treated with harmonic scalpel(n=24)and monopolar electro-surgical scissors(n=22).Perioperative results were collected from two groups.The clinical and pathological characteristics of two groups were similar.The intraoperative and postoperative conditions between the two groups were compared.Results:The amount of bleeding during operation in da Vinci robotic group was 55.0±22.2mL and 81.5±72.5mL in laparoscopic group(P<0.05).The time of postoperative urinary catheter in da Vinci robotic group was 4.1±1.5d and 4.8±1.2d in laparoscopic group(P<0.01).No significant difference between two groups was present postoperatively including anal exhaust time,feeding time,lymph node of detection and morbidity such as anastomotic leakage and hospital stay(P>0.05).As for da Vinci robotic assisted anterior resection,the operation time in monopolar electro-surgical scissors group was 81.5±13.9min and 95.6±21.4min in harmonic scalpel group(P<0.01).The amount of bleeding during operation in monopolar electro-surgical scissors group was 48.6±19.4mL and 61.8±24.2mL in harmonic scalpel group(P<0.05).The time of postoperation urinary catheter in monopolar electro-surgical scissors group was 3.7±1.2d and 4.6±1.7d in harmonic scalpel group(P<0.05).No significant difference between two groups was present postoperatively including anal exhaust time,feeding time,morbidity such as anastomotic leakage,lymph node of detection and hospital stay(P>0.05).Conclusions:Da Vinci robotic assisted anterior resection for rectal cancer has advantage in less bleeding and protection of bladder function and better postoperative recovery compared with laparoscopic assisted anterior resection.Application of monopolar electro-surgical scissors in da Vinci robotic assisted anterior resection for rectal cancer has advantage in less operation time,less bleeding and protection of bladder function and better postoperative recovery compared with application of harmonic scalpel.