Cancer Res Treat.  2016 Jan;48(1):225-231. 10.4143/crt.2014.365.

Robotic Versus Laparoscopic Surgery for Rectal Cancer after Preoperative Chemoradiotherapy: Case-Matched Study of Short-Term Outcomes

• Kim YS
• Kim MJ
• Park SC
• Sohn DK
• Kim DY
• Chang HJ
• Nam BH
• Oh JH

• KMID: 2152279
• DOI: http://doi.org/10.4143/crt.2014.365

Abstract

PURPOSE
Robotic surgery is expected to have advantages over laparoscopic surgery; however, there are limited data regarding the feasibility of robotic surgery for rectal cancer after preoperative chemoradiotherapy (CRT). Therefore, we evaluated the short-term outcomes of robotic surgery for rectal cancer.
MATERIALS AND METHODS
Thirty-three patients with cT3N0-2 rectal cancer after preoperative CRT who underwent robotic low anterior resection (R-LAR) between March 2010 and January 2012 were matched with 66 patients undergoing laparoscopic low anterior resection (L-LAR). Perioperative clinical outcomes and pathological data were compared between the two groups.
RESULTS
Patient characteristics did not differ significantly different between groups. The mean operation time was 441 minutes (R-LAR) versus 277 minutes (L-LAR, p < 0.001). The open conversion rate was 6.1% in the R-LAR group and 0% in the L-LAR group (p=0.11). There were no significant differences in the time to flatus passage, length of hospital stay, and postoperative morbidity. In pathological review, the mean number of harvested lymph nodes was 22.3 in R-LAR and 21.6 in L-LAR (p=0.82). Involvement of circumferential resection margin was positive in 16.1% and 6.7%, respectively (p=0.42). Total mesorectal excision (TME) quality was complete in 97.0% in R-LAR and 91.0% in L-LAR (p=0.41).
CONCLUSION
In our study, short-term outcomes of robotic surgery for rectal cancer after CRT were similar to those of laparoscopic surgery in respect to bowel function recovery, morbidity, and TME quality. Well-designed clinical trials are needed to evaluate the functional results and long-term outcomes of robotic surgery for rectal cancer.

Keyword

Rectal neoplasms; Robotic surgical procedures; Laparoscopy

MeSH Terms

Chemoradiotherapy*
Flatulence
Humans
Laparoscopy*
Length of Stay
Lymph Nodes
Recovery of Function
Rectal Neoplasms*

Reference

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