Exploring the effect of Da Vinci robot contrast laparoscopy to close the pelvic floor peritoneum combined with extraperitoneal stoma in abdominoperineal resection(APR) for low rectal cancer.

The clinical data of patients with low rectal cancer who underwent APR surgery at Gastrointestinal Center of Northern Jiangsu People's Hospital from May 2019 to May 2022 were retrospectively analyzed and divided into RAPR group (28 cases of Da Vinci robot surgery) and LAPR group (31 cases of laparoscopic surgery) according to the surgical method.

There were no statistically significant differences in intraoperative bleeding, time to first defecation, time to drainage tube removal, time to urinary catheter removal, hospital stay, tumor diameter, tumor differentiation degree, TNM stage, postoperative stoma complications, some postoperative perineal complications and male sexuality between the two groups (P＞0.05), and the RAPR group had a longer operative time compared to the LAPR group (185.2±36.1 min vs. 153.5±34.2 min, t=3.467, P=0.001), and also improved the number of lymph node dissection (16.5±3.8 vs. 14.3±3.5, t=2.322, P=0.024), and have a low rate of perineal incision infection (7.1% vs. 29.0%, χ²=4.647, P=0.045), low rate of perineal incision dehiscence (3.6% vs. 25.8%, P=0.027), and patients had less postoperative nocturnal urination (1.00±0.82 vs. 1.48±0.89, t=-2.169, P=0.034) and better voiding function (P=0.026).

The use of the Da Vinci robot for pelvic floor peritoneal closure combined with an extraperitoneal stoma is safe and feasible, and can improve the number of lymph nodes cleared and reduce the incidence of some complications, and provide patients with fewer postoperative nocturnal urinations and better voiding function, which has some practical value in clinical practice.