title: Robotic rectal resection for cancer: a prospective cohort study to analyze surgical, clinical and oncological outcomes.
abstract: OBJECTIVE
  Robotic systems are getting widely spread in recent years given the different technical advantages over traditional laparoscopy. Rectal surgery seems to benefit from this approach, for its ability to easily work in a confined space such as the pelvic cavity. The objective is to present results obtained by the robotic approach in patients with rectal cancer and to give technical considerations.
  
  
  METHODS
  Data were prospectively collected in order to evaluate surgical and oncological outcomes. Subjects underwent robotic rectal resection in the period between June 2011 and June 2014 at the Department of Digestive Surgery, "S. Maria" Hospital - Terni (Italy).
  
  
  METHODS
  Patient characteristics and tumor, overall operative time, conversion to open surgery, site of mini-laparotomy for specimen extraction, intraoperative blood loss, intraoperative complications, time to first bowel movement, time-to-liquid and solid intake, postoperative complications, mortality, hospital stay, thirty-day complications, histopathological examination.
  
  
  RESULTS
  40 consecutive patients underwent robotic resection of the rectum. Median operative time was 340 min (235-460 min), no procedure was converted. Median hospital stay was 5 days (3-18 days). Mesorectum resection was complete in all patients. Median number of harvested lymph nodes was 19 (6-35), median distal resection margin was 4 cm (2-8 cm).
  
  
  CONCLUSIONS
  Robotic rectal surgery is safe and feasible in particular by facilitating the surgeon during the delicate phases of tissue dissection.
authors.affiliation: Department of Digestive Surgery and Liver Unit, St. Maria Hospital, Terni, Italy. Electronic address: amilcareparisi@virgilio.it.
authors.forename: Amilcare
authors.initials: A
authors.lastname: Parisi
authors.affiliation: Department of Digestive Surgery and Liver Unit, St. Maria Hospital, Terni, Italy. Electronic address: djdesi85@hotmail.it.
authors.forename: Jacopo
authors.initials: J
authors.lastname: Desiderio
authors.affiliation: Department of Digestive Surgery and Liver Unit, St. Maria Hospital, Terni, Italy. Electronic address: chirdig@libero.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Trastulli
authors.affiliation: Department of Digestive Surgery and Liver Unit, St. Maria Hospital, Terni, Italy. Electronic address: cirocchiroberto@yahoo.it.
authors.forename: Roberto
authors.initials: R
authors.lastname: Cirocchi
authors.affiliation: Department of Digestive Surgery and Liver Unit, St. Maria Hospital, Terni, Italy. Electronic address: f.fricci@libero.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Ricci
authors.affiliation: Department of Digestive Surgery and Liver Unit, St. Maria Hospital, Terni, Italy. Electronic address: fedrico.farinacci@gmail.com.
authors.forename: Federico
authors.initials: F
authors.lastname: Farinacci
authors.affiliation: Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy. Electronic address: giulio116@hotmail.it.
authors.forename: Antongiulio
authors.initials: A
authors.lastname: Mangia
authors.affiliation: Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy. Electronic address: carloboselli@yahoo.it.
authors.forename: Carlo
authors.initials: C
authors.lastname: Boselli
authors.affiliation: Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy. Electronic address: gnoya@unipg.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Noya
authors.affiliation: Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy. Electronic address: angelo.filippini@uniroma1.it.
authors.forename: Angelo
authors.initials: A
authors.lastname: Filippini
authors.affiliation: Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy. Electronic address: vito.dandrea@uniroma1.it.
authors.forename: Vito
authors.initials: V
authors.lastname: D'Andrea
authors.affiliation: Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy. Electronic address: albert.santoro@tiscali.it.
authors.forename: Alberto
authors.initials: A
authors.lastname: Santoro
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D013505:Digestive System Surgical Procedures / Q000379:methods; D005260:Female; D006801:Humans; D007558:Italy; D010535:Laparoscopy / Q000379:methods; D007902:Length of Stay; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000601:surgery; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D065287:Robotic Surgical Procedures / Q000009:adverse effects
keywords: Rectal cancer; Robotic mesorectal excision; Robotic surgery