Comparative Investigation Between Robot-assisted Laparoscopic Radical Cystectomy And Conventional Laparoscopic Radical Cystectomy For Management Of Bladder Cancer

ObjectivesTo observational comparison studies of perioperative outcomes between robotic-assisted laparoscopic radical cystectomy (RARC) and laparoscopic radical cystectomy (LRC). To analysis the technical characteristics of robotic-assisted laparoscopic radical cystectomy and investigate the safety and feasibility of the robotic-assisted laparoscopic radical cystectomy for the treatment of muscle invasive bladder cancer.Subjects and Methods73 cases of robotic-assisted laparoscopic radical cystectomy and 45 cases of laparoscopic radical cystectomy were performed from October 2013 to November 2015 in our hospital, analyze and summarize the clinical efficacy of them. Then the gender, age, operative time, cystectomy time, blood loss, intraoperative transfusion rate, postoperative gastrointestinal function recovery time, postoperative hospital stay, complications rate and classification and pathological findings were analyzed and compared. To analysis the technical characteristics of robotic-assisted laparoscopic radical cystectomy and investigate the safety and feasibility of robotic-assisted laparoscopic radical cystectomy for the treatment of muscle invasive bladder cancerResultsAll cases were successful completed, no conversion to open operation. There was no significant difference between robotic-assisted surgery and laparoscopic group in age and sex (P> 0.05).The cystectomy operating time was (73.4+18.9) min in robotic surgery group and (92.4 ± 21.2)min in laparoscopic surgery group (P< 0.05).The blood loss was (289.2±161.3)ml in robotic surgery group and (386.6±176.3)ml in laparoscopic surgery group(P< 0.05). The robotic surgery blood transfusion rate was 16.4% and the laparoscopic surgery blood transfusion rate was 35.6%(P<0.05). The exhausting time was (3.4±1.1)d in robotic surgery group and (4.8±1.9)d in laparoscopic surgery group (P< 0.05). The postoperative hospital stay of robotic surgery group was (11.2±3.3) d and laparoscopic surgery group was (15.6±6.8) d (P<0.05).The postoperative complication rate of robotic surgery group was 13.7%　and the laparoscopic surgery group was 18.8%(P<0.05). The two groups had no differences in the positive lymph node-positive rate, postoperative pathological type, tumor grade and stage and postoperative new bladder urinary.ConclusionCompared with laparoscopic radical cystectomy, robotic-assisted laparoscopic radical cystectomy with modified integral method can significantly shorten the operation time, reduce the amount of bleeding and complications, and surgery tended to be simplified so that complex and procedures. The recent results were satisfactory, it is worthy of further application.