Matching Analysis Of Clinical Efficacy Of Robot And Laparoscopic Natural Orifice Specimen Extraction Surgery In The Treatment Of Rectal Cancer

Objective:To compare the short-term efficacy of robot-assisted natural lumen specimen extraction and laparoscopic natural lumen specimen extraction in the treatment of rectal cancer.Methods:The clinical data of 154 patients who underwent robot-assisted or laparoscopic rectal cancer extraction from natural cavity specimens in the three Gorges Hospital affiliated to Chongqing University from August 2018 to August 2021 were analyzed retrospectively.Propensity score matchingmethod was used for 1:1 matching.46 patients in robot group and 46 patients in laparoscopy group were successfully matched.The short-term efficacy and complications of the two groups were compared by rank sum test or χ2test,t test and Mann-WhitneyU test.Results:There was no significant difference in the general data between the two groups(P>0.05).Both groups of patients successfully completed thenatural orifice specimen extraction surgery,and there was no conversion to laparotomyand perioperative period death.Robotic surgery was found to be associated with less intraoperative blood loss than laparoscopic surgery(51.9±15.6 ml vs 59.7 ± 13.8 ml,P<0.05).Robotic surgery was found to be associated with less time to exhaust than laparoscopic surgery(2.6±0.7 d vs 3.2±1.1 d,P<0.05).In terms of postoperative recovery,there was no significant difference between the two groups in the time of getting out of bed for the first time,postoperative pain score,postoperative hospital stay,the number of lymph node dissection and the time of first eating after operation.In terms of postoperative complications,there were 2 cases of anastomotic fistula and 1 case of abdominal infection in the robot group,2 cases of anastomotic fistula and 2 cases of intestinal obstruction in the laparoscopic group,and the incidence of complications in the robot group was lower than that in the laparoscopic group(6.5%vs 8.7%P>0.05).But there was no significant statistical difference.Conclusion:Robot-assisted natural orifice specimen extraction surgery is safe and feasible,which reduces the amount of blood loss compared with laparoscopic natural orifice specimen extraction surgery,and has certain advantages in promoting the recovery of gastrointestinal function after operation.