Multicentric Study on Robotic Tumor-Specific Mesorectal Excision for the Treatment of Rectal Cancer
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Recently, traditional laparoscopic anterior resection has been used for rectal cancer, offering good functional results compared with open resection and resulting in better early postoperative outcomes. Few studies investigating the role of robot-assisted tumor-specific rectal surgery (RTSRS) have been carried out to show its feasibility. The aim of the study was to verify on a multicentric basis the perioperative and oncologic outcome of RTSRS.
One hundred forty-three consecutive patients undergoing RTSR in three centers were reviewed. Pathologic data, and postoperative and oncologic outcome measures were prospectively collected and analyzed by an independent researcher.
A total of 112 restorative surgeries and 31 abdominoperineal resections were carried out. Conversion rate was 4.9%, mean blood loss was 283 ml, and mean operative time was 297 min. The number of harvested nodes (14.1 ± 6.5) and margin status compared favorably with those of open series (mean distal margin 2.9 ± 1.8 cm; negative radial margin in 142 cases). The 3-year overall survival rate was 97%, and no isolated local recurrences were found at mean follow-up of 17.4 months.
RTSRS is a safe and feasible procedure that may facilitate mesorectal excision. Randomized clinical trials and longer follow-up are needed to evaluate a possible influence of RTSRS on patient survival.
KeywordsRectal Cancer Total Mesorectal Excision Oncologic Outcome Rectal Surgery Circumferential Resection Margin
- 20.Ceelen WP, Van Nieuwenhove Y, Fierens K. Preoperative chemoradiation versus radiation alone for stage II and III resectable rectal cancer. Cochrane Database Syst Rev. 2009(1):CD006041.Google Scholar
- 26.Strohlein MA, Grutzner KU, Jauch KW, Heiss MM. Comparison of laparoscopic vs. open access surgery in patients with rectal cancer: a prospective analysis. Dis Colon Rectum. 2008;51(4):385–91.Google Scholar
- 31.Jayaraman S, Quan D, Al-Ghamdi I, et al. Does robotic assistance improve efficiency in performing complex minimally invasive surgical procedures? Surg Endosc. 2009 July 25. [Epub ahead of print].Google Scholar