title: Risk factor analysis of postoperative complications after robotic rectal cancer surgery.
abstract: BACKGROUND
  The robotic system has been adopted as the new modality for minimally invasive surgery for rectal cancer. However, analysis of risk factors for complications after robotic rectal cancer surgery (RRS) has been limited. This study aimed to identify the risk factors for complications after RRS.
  
  
  METHODS
  The records of 389 consecutive patients who underwent RRS between June 2006 and October 2010 were retrieved from our prospectively collected database.
  
  
  RESULTS
  The overall complication rate was 19%. The most common complication was anastomotic leakage (7.0%), followed by voiding difficulty, intrapelvic abscess, and ileus/obstruction. Multivariate analysis revealed the following as risk factors for postoperative complications: male gender, history of previous abdominal surgery, and lower tumor level (hazard ratio [HR] = 1.8, 95% confidence interval [CI] = 1.0-3.1, p = 0.041; HR = 2.3; 95% CI = 1.2-4.6, p = 0.012; and HR = 1.9, 95% CI = 1.1-3.3, p = 0.020, respectively). With regard to pelvic septic complications, lower tumor level, large tumor size, and preoperative chemoradiation remained variables that retained their statistical significance in multivariate analysis (HR = 2.6, 95% CI = 1.1-6.1, p = 0.029; HR = 2.7, 95% CI = 1.1-6.1, p = 0.017; HR = 2.9, 95% CI = 1.3-6.5, p = 0.007, respectively). The rate of postoperative complications was not influenced by the difference in laparoscopic surgery experience or the technique of robotic surgery.
  
  
  CONCLUSIONS
  Surgeons should be more cautious with these patient factors to optimize the benefits of robotic rectal resection.
authors.affiliation: Department of Surgery, Yonsei University Health System, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea.
authors.forename: Jeonghyun
authors.initials: J
authors.lastname: Kang
authors.forename: Byung Soh
authors.initials: BS
authors.lastname: Min
authors.forename: Yoon Ah
authors.initials: YA
authors.lastname: Park
authors.forename: Hyuk
authors.initials: H
authors.lastname: Hur
authors.forename: Seung Hyuk
authors.initials: SH
authors.lastname: Baik
authors.forename: Nam Kyu
authors.initials: NK
authors.lastname: Kim
authors.forename: Seung Kook
authors.initials: SK
authors.lastname: Sohn
authors.forename: Kang Young
authors.initials: KY
authors.lastname: Lee
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000601:surgery*; D012307:Risk Factors; D012371:Robotics