| Objectives:With the development of science and technology,continuous reduction of surgical trauma is a relentless pursuit of the surgeon,and the concept of minimally invasive surgery is the compass and driving force for the continuous development and innovation of surgical techniques.Especially since entering the 21 st century,laparoscopic techniques have achieved tremendous success.With the continuous deepening of the application,the drawbacks of laparoscopic surgery are gradually exposed.In this context,the robotic surgical operating system has emerged.The Da Vinci robot as a new concept of minimally invasive surgery further promotes the development of minimally invasive surgical techniques.Da Vinci robot-assisted surgery has begun to develop in all areas of clinical practice,especially in the liver and intestines,urology applications are maturing.In the field of digestive surgery,especially in gastric cancer,rectal cancer,and esophageal cancer resection,great progress has also been made.The Da Vinci robot has unique advantages in the resection of esophageal cancer.However,so far there have been few reports about the Da Vinci robotic surgical system for the treatment of esophageal cancer.Its application value in the field of esophageal cancer treatment remains unclear.This article compares Da Vinci robot-assisted esophageal cancer radical surgery and laparoscopic radical esophageal cancer radical surgery,compares the feasibility of these two surgical methods,tumor radical surgery and clinical efficacy.Methods:The clinical and pathological data of 110 patients with esophageal cancer treated in our hospital from January 2016 to December 2017 were retrospectively analyzed.Among them,53 patients(robot group)were treated with da Vinci robot.In radical esophageal cancer,57 patients(laparoscopic group)underwent laparoscopic radical resection of esophageal cancer.The operative time,lymph node dissection,intraoperative blood loss,and postoperative chest drainage were compared between the study group and the control group.Postoperative thoracic duct placement,postoperative pathological staging,postoperative hospital stay,and postoperative care duration were used to compare the efficacy and safety of the two surgical approaches for esophageal cancer.Results:1.Comparison of general data between patients in the robot and laparoscopic groups There was no significant difference between the robotic group and the laparoscopic group in terms of age,gender,alcohol and tobacco history,tumor location,and preoperative complications(P>0.05).2.TNM staging of esophageal cancer in robotic and laparoscopic patients In the robotics group,TNM staging after surgery was as follows: 20 cases in stage I,9cases in stage IA,and 11 cases in stage IB;12 cases in stage II,7 cases in stage IIA,5cases in stage IIB,and 3 cases in stage IIIA.The TNM staging of patients undergoing thoracoscopic and laparoscopic surgery was as follows: 43 cases in stage I,20 cases in stage IA,and 23 cases in stage IB;25 cases in stage II,16 cases in stage IIA,9 cases in stage IIB,and 7 cases in stage IIIA.Robots There was no significant difference in the proportion of TNM staging between esophageal cancer patients and thoracic laparoscopy group(P>0.05).3.Comparison of perioperative conditions between the robotic and laparoscopic groups The operation time of the robot group was significantly longer than that of the laparoscopic group(P<0.05);the operation time of the robot group was significantly longer than that of the laparoscopic group(P<0.05);the intraoperative blood loss of the robot group was significantly less than the laparoscopic group(P<0.05).The number of patients undergoing lymph node dissection in the robot group was significantly more than that in the laparoscopic group(P<0.05).The patients in the robot group had significantly less drainage,hospitalization costs,and postoperative chest tube placement time than those in the laparoscopic group(P<0.05).There was no significant difference between the robotic group and the patients in the laparoscopic group(P>0.05).4.Comparison of lymph node dissection between robotic and laparoscopic groups The number of thoracic and ventral lymph node dissections,the number of paraesophageal lymph node dissections,the number of paratracheal lymph node dissections,the number of subcarinal lymph node dissections,and the number of para-paraveneral lymph node dissections were significantly more in the robotics group than in the laparoscopic group.The difference was statistically significant.(P<0.05).5.Comparison of postoperative complications between robotic and laparoscopic groups Postoperative complications in the robot group: 1 case of anastomotic leakage,0 case of anastomotic stenosis,1 case of gastric emptying disorder,1 case of pulmonary infection,1 case of atelectasis,1 case of pneumothorax,and complication rate 14.29%;Postoperative complications in the thoracoscopic and laparoscopic group: 2 cases of anastomotic leakage,2 cases of anastomotic stenosis,2 cases of gastric emptying disorder,5 cases of pulmonary infection,4 cases of atelectasis,3 cases of pneumothorax,The incidence of complications was 24.00%;the incidence of postoperative complications in the two groups was statistically significant(P<0.05).Conclusions:1.Da Vinci robot-assisted esophageal cancer radical surgery compared with laparoscopic radical surgery for esophageal cancer,the former clinical treatment is better,Da Vinci robot assisted esophageal cancer radical surgery can achieve radical esophageal cancer surgery.2.Compared with laparoscopic radical surgery for esophageal cancer,Da Vinci robot-assisted lymph node dissection for radical esophageal cancer surgery is more thorough and less intraoperative blood loss,which is beneficial to the prognosis of patients.3.The Da Vinci robot-assisted radical esophageal carcinoma has a good short-term clinical efficacy and is a safe and feasible surgical method. |
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