Clinical Studies Of Da Vinci ? Robot Assisted Radical Right Hemi-colectomy

Part I Retrospective Matched Case-control Study of Da Vinci ?Robot Assisted Radical Right Hemi-colectomy and Laparoscopic Radical Right Hemi-colectomy Treated in the Same PeriodObjective: by Da Vinci ? robot assisted radical right hemi-colectomy and laparoscopic radical right hemi-colectomy comparison,analysis of assisted the safety and the feasibility of Da Vinci ? robot assisted radical right hemi-colectomy and whether there is advantage;Methods: retrospectively analysis the cases of Da Vinci ? robot assisted radical right hemi-colectomy(experimental group)from September 1,2015 to December 31,2018,using propensity score matching method,according to the patient's age,sex,body mass index,the American society of anesthesiologists score,abdominal surgery history,history of disease and preoperative tumor,clinical stage in a ratio of 1:1,with the same period of laparoscopic radical right hemi-colectomy(control group)were compared,compare the intraoperative and postoperative short-term prognosis and postoperative pathology,carries on the analysis comparison;Results: a total of 52 cases in the experimental group were collected,154 cases in the control group,and 28 cases were successfully matched.The average operation time of the experimental group was(175±44)minutes,and that of the control group was(169±49)minutes.Median intraoperative blood loss was 50(10-100)ml in the experimental group and 50(30-100)in the control group.There was no significant difference between the two groups(P=0.66,P=0.88).No transit and no short-term postoperative complications were found in both groups.The average postoperative fluid intake time of the experimental group was(4.0±1.7)days,while that of the control group was(4.1±1.7)days.The postoperative hospitalization days in the experimental group were(6.4±0.8)days,while the average postoperative hospitalization days in the control group were(6.1±1.3)days.There was no significant difference between the two groups(P=0.84,P=0.53).The mean number of lymph nodes(19.0±8.1)in the test group was 1(0-3),and the mean number of lymph nodes(21.4±6.2)in the control group was 1(0-4).There was no significant difference between the two groups(P=0.24,P=0.70).Conclusion: Da Vinci ? robot assisted radical right hemi-colectomy is safe and feasible no clear advantage compared with laparoscopic radical right hemi-colectomy,such as extensive still needs further study.Part II Learning Curve of Da Vinci ? Robot Assisted Radical Right Hemi-colectomyObjective: to draw the learning curve of Da Vinci ? robot assisted radical right hemi-colectomy to carry out the initial difficulties and learning patterns;Methods: retrospectively analysis the continuous cases of Da Vinci ? robot assisted radical right hemi-colectomy conducted by the same doctor from September 1,2015 to December 31,2018,by cumulative sum method,analysis of the operation time,intraoperative blood loss,surgical transfer rate,postoperative gastrointestinal function recovery time,postoperative hospitalization time after operation,postoperative complications and short-term sweeping change,the number of lymph nodes in learning curve drawing;Results: a total of 50 cases,through the cumulative sum method to draw the learning curve,11 cases after the operation,the curve slope is stable negative,prompt Da Vinci ? robot assisted radical right hemi-colectomy after 11 cases through the learning curve;Conclusion: as for skilled laparoscopic surgical experience of the surgeon,the learning curve of Da Vinci ? robot assisted radical right hemi-colectomy is get through after 11 cases.