title: Long-term oncologic outcomes of robotic low anterior resection for rectal cancer: a comparative study with laparoscopic surgery.
abstract: OBJECTIVE
  The aim of this study is to evaluate long-term oncologic outcomes of robotic surgery for rectal cancer compared with laparoscopic surgery at a single institution.
  
  
  BACKGROUND
  Robotic surgery is regarded as a new modality to surpass the technical limitations of conventional surgery. Short-term outcomes of robotic surgery for rectal cancer were acceptable in previous reports. However, evidence of long-term feasibility and oncologic safety is required.
  
  
  METHODS
  Between April 2006 and August 2011, 217 patients who underwent minimally invasive surgery for rectal cancer with stage I-III disease were enrolled prospectively (robot, n = 133; laparoscopy, n = 84). Median follow-up period was 58 months (range, 4-80 months). Perioperative clinicopathologic outcomes, morbidities, 5-year survival rates, prognostic factors, and cost were evaluated.
  
  
  RESULTS
  Perioperative clinicopathologic outcomes demonstrated no significant differences except for the conversion rate and length of hospital stay. The 5-year overall survival rate was 92.8% in robotic, and 93.5% in laparoscopic surgical procedures (P = 0.829). The 5-year disease-free survival rate was 81.9% and 78.7%, respectively (P = 0.547). Local recurrence was similar: 2.3% and 1.2% (P = 0.649). According to the univariate analysis, this type of surgical approach was not a prognostic factor for long-term survival. The patient's mean payment for robotic surgery was approximately 2.34 times higher than laparoscopic surgery.
  
  
  CONCLUSIONS
  No significant differences were found in the 5-year overall, disease-free survival and local recurrence rates between robotic and laparoscopic surgical procedures. We concluded that robotic surgery for rectal cancer failed to offer any oncologic or clinical benefits as compared with laparoscopy despite an increased cost.
authors.affiliation: Section of Colon and Rectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Eun Jung
authors.initials: EJ
authors.lastname: Park
authors.forename: Min Soo
authors.initials: MS
authors.lastname: Cho
authors.forename: Se Jin
authors.initials: SJ
authors.lastname: Baek
authors.forename: Hyuk
authors.initials: H
authors.lastname: Hur
authors.forename: Byung Soh
authors.initials: BS
authors.lastname: Min
authors.forename: Seung Hyuk
authors.initials: SH
authors.lastname: Baik
authors.forename: Kang Young
authors.initials: KY
authors.lastname: Lee
authors.forename: Nam Kyu
authors.initials: NK
authors.lastname: Kim
mesh_terms: D000230:Adenocarcinoma / Q000191:economics / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059186:Chemoradiotherapy, Adjuvant; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000191:economics / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000191:economics / Q000473:pathology / Q000601:surgery*; D012371:Robotics / Q000191:economics / Q000379:methods*; D015996:Survival Rate; D016896:Treatment Outcome