Comparative Analysis Of Clinical Efficacy Between Robot-Assisted Laparoscopic And Traditional Laparoscopy In The Treatment Of High-Risk Prostate Cancer

Objective:To investigate the clinical efficacy of robot-assistedlaparoscopic and traditional laparoscopic treatment of high-risk prostate cancer.Methods:A retrospective analysis of 68 patients with high-risk prostate cancer who were admitted to our hospital from March 2011 to August 2018(according to the D'Amico grading criteria)was divided into two groups according to different surgical methods.37 patients underwent radical laparoscopic radical prostatectomy and 31 patients underwent traditional laparoscopic surgery.Then we will make a comparison among thereoperative general data,operation time,intraoperative blood loss,postoperative hospital stay,drainage tube removal time,Surgical complications,positive surgical margin,biochemical recurrence rate,postoperative urinary control recovery,recent(4 years)tumor recurrence-free survival rate and overall survival rate.The data were processed and analyzed by statistical software SPSS 20.0.The measurement data were tested by two independent samples,the chi-square test was used for the count data,and the cumulative survival function was plotted by Kaplan-Meier method.The difference was statistically significant at P<0.05.Results:All the 68 patients underwent radical prostatectomy and pelvic lymphadenectomy under general anesthesia.There was no one change to open surgery.All patients were treated with androgen deprivation therapy.There was no significant difference(P>0.05)in the mean age of patients(68.35 years vs.67.54 years),preoperative serum total PSA values(69.11±42.74 ng/ml vs 92.11±88.71 ng/ml),PSAD(2.32±1.72 VS 2.49±2.91),preoperative Gleason score,prostate volume and pathological stage between the traditional laparoscopic and robotic groups.The intraoperative blood loss(222.74±70.01 ml vs 167.57±44.35ml)and postoperative hospital stay(12.77±6.83 d VS 9.54±3.2d),pelvic drainage tube removal time(8.87±5.92 d VS 5.87±2.77d)were statistically significant(P<0.05);There was also no significant difference among operation time(248.23±46.87 min VS 243.11±41.32min),urinary catheter removal time(15.9 ± 4.31 dVS 14.7 ± 3.51d),lymph node number(11.06 ± 7.26 VS 12.75 ± 7.02),positive margin(32.3% VS 27%),complication rate(16.1% VS 13.5%).The biochemical recurrence rate of PSA after operation in the two groups(70.9% vs 35%)has significant statistical difference;Immediate urinary control after removal of the catheter(22.6% VS 56.7%),3-month urinary recovery rate(54.85% VS 81.1%),12-month urinary recovery rate(8 3.8% VS 97.2%),all of which were statistical differences,in contrast,the urine control rate in 6-month(71% vs 89.1%)and 24-month(96.7% vs 100%)were no statistical difference.The recurrence-free survival rate of the patients,who were underwent the traditional laparoscopic surgery,was 96.8%?90.3%,and 90.3% at1?3? 4 years,respectively,however,the robot-assisted group was 100%?97.3%,and 97.3% at the same time.But there was no significant difference between the two groups.The total survival rate of the two groups were 100%?100%?100%,100%?97.3%?97.3%,respectively,yet,the result is the same as before.Conclusion:Despite the short using time of the robotic-assisted surgery,this technology that is used to treat the high-risk prostate cancer is clinically satisfactory,safe and reliable.On the one hand it can effectivly reduce the difficulty of the surgery,the operator's fatigue,intraoperative blood loss,postoperative hospital stay,postoperative PSA biochemical recurrence rate and improve the patients' recent urinary control ability,One the other hand it can still maintain a good prognostic effect,which has certain advantages and deserves further promotion.