A Comparative Study Of Da Vinci Robot And Laparoscopy In The Treatment Of The Middle And Low Rectal Cancer

Objective: To compare the short-term surgical effect of Da Vinci robot and laparoscopy in the treatment of middle and low rectal cancer and the complications within 30 days after operation.Methods: Retrospective analysis of the clinical data of 161 patients with middle and low rectal cancer in the Anorectal Department of Gansu Provincial Hospital from January 2016 to June 2017,including 59 cases who have received the Da Vinci robot of mid-low rectal cancer resection(referred as the robotic group),102 cases have underwent laparoscopic mid-low rectal cancer radical resection(referred as the laparoscopic group).Results: There was no statistical difference in the basic characteristics of patients between the two groups(P > 0.05).But in the blood loss,operation time and the total cost,the robotic group was significantly longer than that in the laparoscopic group,there was significant difference(P < 0.05).The robotic group was better than the laparoscopic group in the conversion rate,postoperative hospital stay,postoperative first ventilation time and the first time of liquid diet,and there was significant difference(P < 0.05).The two groups within 30 days after surgery,the overall complication rate,intraoperative blood transfusion,postoperative CEA,total pelvic drainage,postoperative drainage tube indwelling time and the pathology showed no statistical difference(P > 0.05).According to the multivariate linear regression analysis,the operation time was closely related to the intraoperative blood loss [Coe=0.19,95%CI(0.08,0.30);P=0.001].The intraoperative blood loss was closely related to the tumor size [Coe=1.02 95%CI(0.48,1.56);P=0.000].The time of first ventilation after the operation was mainly related to postoperative pathological stage Ⅳ [Coe=4.28 and 95%CI(0.59,7.96),and P=0.023] and operation time[Coe=0.01,95%CI(0.00,0.02),P=0.023],and all had statistical significance(P < 0.05).Conclusion: Da Vinci’s robot and laparoscopy are safe and feasible in the treatment of middle and low rectal cancer,and have similar postoperative pathological results.Compared to the laparoscopic group,the robotic group has the advantages of fast recovery time,shorter postoperative hospital stay and lower conversion rate.It can be used as a first choice for the treatment of middle and low rectal cancer.However,high cost,more bleeding and longer operation time are shortcomings of robotic rectal surgery at present.