Clinical Analysis Of Da Vinci Robotic-assisted Laparoscopic Staging Of Endometrial Cancer

BackgroundEndometrial carcinoma is the most common tumor in the female reproductive tract.More than 90% of endometrial cancer cases occur in women over the age of 50,the mean age of diagnosis is 63 years old.Most early stage endometrial cancer have a five-year survival rate of more than 95%.However,the five-year survival rate is much lower.In the late stage cases or there being distant metastasis.Although most cases of endometrial cancer are diagnosed at an early stage,differences in the degree of differentiation and pathological type of the patient’s tumor may affect the prognosis of the patient,meanwhile,the treatment may vary.With the development of robotic-assisted surgery,many of the technical challenges of conventional laparoscopic surgery have been eliminated.Robotic-assisted surgery has many advantages,including less blood loss and shorter operation time.These advantages may reduce patient’s postoperative recovery time.Laparoscopic surgery has replaced laparotomy surgery owing to its Smaller incision,less trauma,less blood loss.Although traditional laparoscopic surgery has achieved minimally invasive surgery,there are still many defects,such as: unclear vision,intraoperative tremors,human resources consumption,etc.Nowadays,With the development of science and technology,Da Vinci robotic surgery system has developed into a leading way of minimally invasive surgery.ObjectiveIn this article,through analysis of the clinical data of endometrial carcinoma patients of laparoscopic comprehensive staging surgery and robotic-assisted comprehensive staging surgery to explore the safety and feasibility of Da Vinci robotic surgery system in the comprehensive staging surgery for endometrial cancer.MethodsA Retrospective analysis was made on the clinical data of 204 cases of endometrial cancer who received comprehensive staging surgery in the First Affiliated Hospital of Zhengzhou University from January 2015 to August 2018,involving 96 cases of Robotic-assisted group and 108 cases of laparoscopic group.The comparison between the two groups consist of intraoperative section and postoperative section: operation time,intraoperative blood loss,number of lymph nodes removed during the surgery,intraoperative complication;postoperative venting time,postoperative average hospitalization days,postoperative complication and indicators of recurrence or metastasis during the follow-up period.ResultsBoth groups of patients completed the surgery successfully,and there was no conversion to laparotomy surgery during the operation.The robotic-assisted group had less intraoperative blood loss and the operation time than laparoscopic group(P<0.05),the number of lymph nodes removed during the surgery were larger than those in the laparoscopic group(P<0.05).There was no statistically significant difference between the number of patient who had intraoperative complications(P>0.05).In the postoperative average hospitalization days,the robotic-assisted group was less than laparoscopic group(P<0.05).There were no statistically significant differences between the two groups in the postoperative venting time,postoperative average hospitalization days,and postoperative complications and indicators of recurrence or metastasis during the follow-up period(P>0.05).As for Intraoperative complications,there was no complications in the robotic-assisted group,meanwhile,one case of ureteral injury(surgical repair,ureteral replantation)and one case of severe intestinal injury due to adhesion(intraoperative repair)occurred in the laparoscopic group,.The patient was followed up after the end of the treatment.The follow-up period was 6-30 months,and the median follow-up period was 24 months.After gynecological examination,imaging examination and gynecological liquid-based exfoliative cytology examination of vaginal stump,no significant recurrence or metastasis was observed during the follow-up period.ConclusionCompared with laparoscopic group,robotic-assisted group have the advantage in Intraoperative blood loss,operation time and the number of lymph nodes removed during the surgery.It proves that the clinical application of the Da Vinci robotic surgery system in the comprehensive staging of endometrial cancer is safe and feasible,and has certain advantages.It could be a new choice for endometrial cancer comprehensive staging surgery.