Comparison Of Clinical Efficacy Between Da Vinci Robotic And Laparoscopic Surgery In The Treatment Of Rectal Cancer

Objective:By comparing the various perioperative indicators of robotic and laparoscopic radical resection surgery,the purpose of this study was to evaluate their clinical efficacy and explored the potential advantages of robotic surgery in the difficult cases of low rectal cancer,obesity and narrow pelvic.Methods:Aretrospective case-control study was conducted on 79 patients with rectal cancer admitted to the Second Clinical Medical College of Jinan University from November 2020 to December 2021.The relevant perioperative indicators were observed,and analyzed in the two groups.Results: 1.General conditions: there were no statistical differences between the two groups in terms of age,ASA score,underlying disease,history of abdominal surgery,and neoadjuvant therapy.The proportion of male patients was higher in the robotic group than in the laparoscopic group(75.0% vs51.0%,P=0.038);the proportion of overweight or obese patients with BMI > 24.0 was higher in the robotic group than in the laparoscopic group(60.7% vs 23.5%,P=0.001);the distance between the tumor and the anal margin was closer in the robotic group than in the laparoscopic group(71 mm vs 91 mm,P=0.022).2.Surgical situations: there was no statistical difference between the two groups in terms of intraoperative bleeding,number of preventive stoma cases,and number of combined other non-major organ resections cases.The operative time was longer in the robotic group than in the laparoscopic group(359 min vs.252 min,P < 0.001).3.Pathological examinations: there was no statistical difference between the surgical specimens of the two groups in terms of the mesorectum completeness,tumor TNM stage,surgical margin negativity rate,and the number of lymph node dissections.4.Postoperative recovery: there were no statistical differences between the two groups in terms of first exhaust time,first off-bed exercise time,first intake food time,Postoperative hospital stay,first abdominal drainage tube removal time,Postoperative body temperature difference,number of postoperative blood transfusion cases,and number of postoperative complications cases.The robotic group had lower scores on the Wexner scoring system for fecal incontinence than the laparoscopic group(3 vs 4,P=0.036).5.Peripheral blood indicators: in the intra-group comparison,WBC,NLR,CRP,IL-6,and TNF-α were significantly higher in both groups postoperatively compared with preoperatively,but there was no statistical difference in the above observation indicators at the same time node of before surgery,1 day after surgery,3 days after surgery and 6 days after surgery between the two groups.Conclusion: 1.The Da Vinci robotic surgery is as safe,effective and feasible as laparoscopic surgery in the treatment of rectal cancer.2.The Da Vinci robotic surgery has potential advantages over laparoscopic surgery in male,obese,low rectal cancer Patients.3.The Da Vinci robotic surgery has more advantages than laparoscopic surgery in protecting defecation function.