Short- and medium-term outcome of robot-assisted and traditional laparoscopic rectal resection.
BACKGROUND
Traditional laparoscopic anterior rectal resection (TLAR) has recently been used for rectal cancer, offering good functional results compared with open anterior resection and resulting in a better postoperative early outcome. However, laparoscopic rectal resection can be technically demanding, especially when a total mesorectal excision is required. The aim of this study was to verify whether robot-assisted anterior rectal resection (RLAR) could overcome limitations of the laparoscopic approach.


METHODS
Sixty-six patients with rectal cancer were enrolled in the study. Twenty-nine patients underwent RLAR and 37 TLAR. Groups were matched for age, BMI, sex ratio, ASA status, and TNM stage, and were followed up for a mean time of 12 months.


RESULTS
Robot-assisted laparoscopic rectal resection results in shorter operative time when a total mesorectal excision is performed (165.9+/-10 vs 210+/-37 minutes; P<0.05). The conversion rate is significantly lower for RLAR (P<0.05). Postoperative morbidity was comparable between groups. Overall survival and disease-free survival were comparable between groups, even though a trend towards better disease-free survival in the RLAR group was observed.


CONCLUSIONS
RLAR is a safe and feasible procedure that facilitates laparoscopic total mesorectal excision. Randomized clinical trials and longer follow-ups are needed to evaluate a possible influence of RLAR on patient survival.
Patriti
Alberto
A
Department of General, Vascular, Minimally Invasive and Robotic Surgery, Hospital San Matteo degli Infermi-Spoleto (PG), Italy. albertopatriti@gmail.com
Ceccarelli
Graziano
G
Bartoli
Alberto
A
Spaziani
Alessandro
A
Biancafarina
Alessia
A
Casciola
Luciano
L
D000368:Aged; D013505:Digestive System Surgical Procedures / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000401:mortality / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D012371:Robotics; D016896:Treatment Outcome