title: Robotic-assisted surgery for rectal adenocarcinoma: short-term and midterm outcomes from 200 consecutive cases at a single institution.
abstract: BACKGROUND
  Although robotic surgery is increasingly used in the management of rectal cancer, its oncologic safety remains uncertain.
  
  
  OBJECTIVE
  We aimed to evaluate the feasibility and safety of robotic-assisted rectal cancer resection in terms of short-term and midterm outcomes.
  
  
  METHODS
  A prospectively collected set of samples was retrospectively evaluated.
  
  
  METHODS
  Data included in this study were collected at a single institution from 2007 to 2011.
  
  
  METHODS
  The study included 200 consecutive rectal cancer patients.
  
  
  METHODS
  The patients underwent robotic-assisted resection surgery performed by a single surgeon.
  
  
  METHODS
  The short-term (surgical outcome and pathologic data) and midterm outcomes (local pelvic control and overall and disease-free survival) were evaluated and compared with those in the published literature.
  
  
  RESULTS
  The median patient age was 60 years, and the male:female ratio was 2:1. The median distance of rectal tumors from the anal verge was 6 cm. Preoperative radiotherapy was performed in 55 patients. The median operation time was 270 minutes, and the median blood loss was 190 mL. Grade 3 to 5 complications, according to the Clavien-Dindo classification, were observed in 15 patients (7.5%). The circumferential resection margin was positive in 5 patients (2.5%). During the median follow-up period of 29.8 months, recurrence occurred in 27 patients (distant metastasis, 18 patients; local recurrence, 7 patients; and both local recurrence and distant metastases, 2 patients). The local pelvic control and overall and disease-free survival rates of stage III patients at 5 years were 93.0%, 88.6%, and 76.6%.
  
  
  CONCLUSIONS
  This was a retrospective, uncontrolled study of selected patients by a single surgeon.
  
  
  CONCLUSIONS
  Our results demonstrated an acceptable morbidity and a low rate of positive circumferential resection margin with effective local control. We also achieved excellent survival data. The midterm oncologic safety justifies the practice of robotic rectal cancer resection to further investigate its role on long-term outcomes.
authors.affiliation: 1Colorectal Division, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea 2Department of Gastroenterological Surgery, Nagoya City University, Mizuho-cho, Mizuho-ku, Nagoya, Japan 3Department of Surgery, Changi General Hospital, Singapore.
authors.forename: Masayasu
authors.initials: M
authors.lastname: Hara
authors.forename: Kevin
authors.initials: K
authors.lastname: Sng
authors.forename: Byung Eun
authors.initials: BE
authors.lastname: Yoo
authors.forename: Jae Won
authors.initials: JW
authors.lastname: Shin
authors.forename: Dong Won
authors.initials: DW
authors.lastname: Lee
authors.forename: Seon Hahn
authors.initials: SH
authors.lastname: Kim
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D061646:Operative Time; D011183:Postoperative Complications; D012004:Rectal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D012189:Retrospective Studies; D012371:Robotics; D015996:Survival Rate; D016896:Treatment Outcome