title: Robotic surgery for rectal cancer: a single center experience of 100 consecutive cases.
abstract: BACKGROUND
  Minimally invasive techniques have revolutionized the field of general surgery over the few last decades. Despite its advantages, in complex procedures such as rectal surgery, laparoscopy has not achieved a high penetration rate because of its steep learning curve, its relatively high conversion rate and technical challenges. The aim of this study was to present a single center experience with robotic surgery for rectal cancer focusing mainly on early and mid-term postoperative outcome.
  
  
  METHODS
  A series of 100 consecutive patients who underwent robotic rectal surgery between January 2008 and June 2012 was analyzed retrospectively in terms of demographics, pathological data, surgical and oncological outcomes.
  
  
  RESULTS
  Seventy-seven patients underwent robotic sphincter-saving resection, and 23 patients underwent robotic abdominoperineal resection. There were 4 conversions. The median operative time for sphincter-saving procedures was 180 min. The median time for robotic abdominoperineal resection was 160 min. The median distal resection margin of the operative specimen was 3 cm. The median number of retrieved lymph nodes was 14. The median hospital stay was 10 days. In-hospital mortality was nil. The overall morbidity was 30%. Four patients presented transitory postoperative urinary dysfunction. Severe erectile dysfunction was reported by 3 patients. The median length of follow-up was 24 months. The 3-year overall survival rate was 90%.
  
  
  CONCLUSIONS
  Robotic surgery is advantageous for both surgeons (in that it facilitates dissection in a narrow pelvis) and patients (in that it affords a very good quality of life via the preservation of sexual and urinary function in the vast majority of patients and it has low morbidity and good midterm oncological outcomes). In rectal cancer surgery, the robotic approach is a promising alternative and is expected to overcome the low penetration rate of laparoscopy in this field.
authors.affiliation: Department of General Surgery and Liver Transplantation "Dan Setlacec", Fundeni Clinical Institute, Bucharest, Romania.
authors.forename: O
authors.initials: O
authors.lastname: Stănciulea
authors.forename: M
authors.initials: M
authors.lastname: Eftimie
authors.forename: L
authors.initials: L
authors.lastname: David
authors.forename: V
authors.initials: V
authors.lastname: Tomulescu
authors.forename: C
authors.initials: C
authors.lastname: Vasilescu
authors.forename: I
authors.initials: I
authors.lastname: Popescu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy / Q000379:methods; D003082:Colectomy / Q000009:adverse effects / Q000379:methods*; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D007172:Erectile Dysfunction / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011300:Preoperative Care; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D012007:Rectum / Q000601:surgery; D012189:Retrospective Studies; D012371:Robotics; D012383:Romania / Q000453:epidemiology; D015996:Survival Rate; D013997:Time Factors; D014555:Urination Disorders / Q000209:etiology