Comparative Analysis Of The Short-term Outcome Between Robotic And Laparoscopic Radical Gastrectomy For Distal Gastric Cancer

Objective:A comparative analysis of the clinical data and short-term efficacy of the Da Vinci robotic surgical system assisting in radical distal gastrectomy and laparoscopic radical gastrectomy,At the same time,the clinical data and the short-term efficacy of robotic distal radical gastrectomy and complete laparoscopic radical gastrectomy were compared.Explore the clinical application of Da Vinci robotic surgical system in radical gastrectomy for gastric cancer.Methods:Retrospective analysis of the robot-assisted distal gastrectomy(robot-assisted group)and laparoscopic assisted distal gastrectomy(laparoscopies)from January2015 to December 2017 in the fifth general department of the First Affiliated Hospital of Nanchang University Auxiliary group)Clinical data and short-term efficacy of 120 patients with gastric cancer.In order to increase the comparability of the study cases,all selected cases were performed by the same treatment group.All surgical methods were distal type II anastomosis of distal gastric cancer.All the patients underwent D2 lymph node dissection and abdominal assisted small incision was used for in vitro digestive tract.reconstruction.The clinical and pathological data recorded in the two groups included gender,age,body mass index(BMI),tumor maximal diameter,TNM stage,number of converted laparotomy,intraoperative blood loss,free time,operation time,first row after operation.Gas timing,the time of first intake of semi-liquid after surgery,the number of lymph nodes detected,the incidence of complications,and hospitalization costs.In the same way,retrospective analysis of the same treatment group in the same treatment group underwent complete robotic distal gastrectomy(all robots)and complete laparoscopic radical gastrectomy(full laparoscopic group)60 cases of gastric cancer patients and clinical data recently Efficacy(In addition to digestivetract reconstruction time).All patients underwent endoscopic reconstitution of the digestive tract.SPSS21.0 statistical software was used to analyze the clinical data and the short-term efficacy of the robot and laparoscopic groups.Results:Robotic-assisted distal gastrectomy and laparoscopy-assisted distal gastrectomy showed statistically significant differences between the two groups:The intraoperative blood loss(ml)(99.30±24.23)was lower in the robot-assisted group than in the laparoscopic-assisted group(166.00 ± 31.66:P<0.001).The number of lymph node dissections in the robot-assisted group(26.57±8.32)was more than that in the laparoscopy-assisted group(21.71 ± 4.24:P<0.001).The first postoperative discharge time(h)(80.16±21.84)was shorter in the robot-assisted group than in the laparoscopy-assisted group(103.68±22.32: P<0.001).Feeding semi-fluid(h)(129.6± 18.96)was shorter in the robot-assisted group than in the laparoscopy-assisted group(144.72 ± 22.32: P<0.001);hospitalization costs in the robot-assisted group(RMB: yuan)(62314.57±10218.83)were more than Laparoscopically assisted group(48321.30 ± 7151.49:P < 0.05).Complete robotic distal gastric cancer radical surgery and complete laparoscopic distal gastric cancer radical mastectomy were compared between the two groups of data,among which the statistical significance included: The total robotic group digestive tract reconstruction time(min)(41.98±10.16)was shorter than that of the full laparoscope.The group(69.35±16.63: P<0.001);The operation time(min)of the robot group(187.43±32.45)was shorter than that of the whole laparoscope group(205.02±22.65: P<0.05);the blood loss in the whole robot group was(ml).(97.83±24.54)was less than the total laparoscopic group(156.50±34.03: P<0.001);the number of lymph node dissections in the whole robot group(26.15±7.09)was more than that in the whole laparoscopic group(21.72 ± 4.30: P<0.001).The first postoperative exhaust time(h)(84±22.8)was lower in the robot group than in the whole laparoscopic group(103.92±26.64: P<0.001);the first postoperative time in the whole robot group(h)(134.4±19.44)It was shorter than the whole laparoscopicgroup(152.4±33.36: P<0.001).The hospitalization cost(RMB: RMB)(61312.83±10899.837)in the robot group was higher than that in the whole laparoscopic group(47075.67±5692.58: P<0.05).Conclusion:Robotic radical surgery for gastric cancer can achieve radical resection of the primary lesions of gastric cancer and thorough lymph node dissection.Compared with laparoscopic surgery,the amount of intraoperative blood loss is less,lymph node dissection is more thorough,and better short-term results can be obtained.In addition,complete robotic distal radical gastrectomy has a shorter operation time than complete laparoscopic radical gastrectomy,especially in the peritoneal cavity for gastrointestinal reconstruction.Therefore,the Da Vinci robotic surgical system is safe and feasible in the surgical treatment of gastric cancer,and it should be strongly advocated for its application in clinical practice.