Multicentric study on robotic tumor-specific mesorectal excision for the treatment of rectal cancer.
BACKGROUND
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Pigazzi
Alessio
A
Division of General and Oncologic Surgery, City of Hope National Medical Center, Duarte, CA, USA. apigazzi@coh.org
Luca
Fabrizio
F
Patriti
Alberto
A
Valvo
Manuela
M
Ceccarelli
Graziano
G
Casciola
Luciano
L
Biffi
Roberto
R
Garcia-Aguilar
Julio
J
Baek
Jeong-Heum
JH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California; D013505:Digestive System Surgical Procedures / Q000295:instrumentation*; D018572:Disease-Free Survival; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007558:Italy; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D012371:Robotics; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome