| Objective:To evaluate the safety feasibility and efficacy of da Vinci robot surgery system in comprehensive staging surgery for the early endometrial cancer.Methods:A retrospective analysis was made on the clinical data of 105 case of endometrial cancer who undergoing Endometrial cancer comprehensive staging,there were 50 patients in the robot group,29 in the laparoscopic group,and 26 in the laparotomy group.Whole uterus and double attachment resection or radical resection+ comprehensive staging.The operation time,intraoperative blood loss,number of resected pelvic and para-aortic lymphadenectomic nodes,postoperative exhaust time,indwelling catheter time,the incidence of postoperative complications and the recurrence rate of 1-2 years follow-up and so on were compared among the three groups.Results:1.Comparison of general data: the age of three groups,the BMI,the FIGO staging,the Shared disease,no apparent difference.2.Intraoperative outcome indicators:(1)Compared with the operation time of the three groups,[(256.0±75.4),(256.0±55.2),(235.4±100.9)min,F=0.686,P=0.506],the difference was not statistically significant.(2)Para-aortic lymph node dissection was performed in 12 cases,4 cases and 2cases in 3 groups,[4(1~16),3.5(1~9),2(1~3),?2 =1.032,P=0.597],maximum number of excision of robot group,but the difference is not statistically significant.(3)Compared with [(29.2±8.4),(22.7±9.7),(20.1±7.0),F=11.754,P=0.000],it is statistically significant that number of pelvic lymph nodes removed of the robot group is at most.(4)The intraoperative blood loss in the 3 groups was compared [(189.0±117.1),(277.6±130.6),(346.2±133.4)ml,F=12.147,P=0.000],and the robot group had theleast amount of bleeding,three groups are statistically significant.(5)Compared with [(3.0±0.9),(3.5±0.9),(4.0±1.3)d,F=8.855,P=0.000],the postoperative exhaust time of the robot group was the shortest,and the two groups were compared.All were statistically significant(P<0.05).(6)Compared with [(4.9±1.6),(6.0±1.7),(6.6±1.4)d,F=11.387,P=0.000],the indwelling catheter time of the robot group was the shortest,there was no significant difference.(7)For the hospital stay [(8.3±2.0),(9.9±3.1),(11.9±3.2)d,F=15.746,P=0.000],the robotic group had the shortest,comparing the two groups was statistically significant.3.Postoperative outcome indexes: postoperative complications of robot group,laparoscopic group and open group were [10%(5/50),27.6%(8/29),42.3%(11/26),?2= 10.634,P=0.005)],the robot group had the least complications,and the difference was statistically significant.4.Follow-up results: 3 groups were followed up for 1~2 years,2 cases in the robot group recurred(4%),1 case(3.4%,3.8%)in the laparoscopic and laparotomy,respectively.The recurrence rate of the 3 groups was not statistical meaning(?2=0.015,P=0.992).Conclusion:Compared with the traditional method,the da Vinci robot surgical system has the advantages of less blood,more elvic lymphadenectomic nodes,shorter postoperative exhaust and indwelling catheter time,fewer complications and shorter hospital stay,similar efficacy,suggesting that robotic surgery is safe,feasible and effective in the treatment of endometrial cancer. |
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