title: Robotic Versus Laparoscopic Surgery for Rectal Cancer after Preoperative Chemoradiotherapy: Case-Matched Study of Short-Term Outcomes.
abstract: OBJECTIVE
  Robotic surgery is expected to have advantages over laparoscopic surgery; however, there are limited data regarding the feasibility of robotic surgery for rectal cancer after preoperative chemoradiotherapy (CRT). Therefore, we evaluated the short-term outcomes of robotic surgery for rectal cancer.
  
  
  METHODS
  Thirty-three patients with cT3N0-2 rectal cancer after preoperative CRT who underwent robotic low anterior resection (R-LAR) between March 2010 and January 2012 were matched with 66 patients undergoing laparoscopic low anterior resection (L-LAR). Perioperative clinical outcomes and pathological data were compared between the two groups.
  
  
  RESULTS
  Patient characteristics did not differ significantly different between groups. The mean operation time was 441 minutes (R-LAR) versus 277 minutes (L-LAR, p < 0.001). The open conversion rate was 6.1% in the R-LAR group and 0% in the L-LAR group (p=0.11). There were no significant differences in the time to flatus passage, length of hospital stay, and postoperative morbidity. In pathological review, the mean number of harvested lymph nodes was 22.3 in R-LAR and 21.6 in L-LAR (p=0.82). Involvement of circumferential resection margin was positive in 16.1% and 6.7%, respectively (p=0.42). Total mesorectal excision (TME) quality was complete in 97.0% in R-LAR and 91.0% in L-LAR (p=0.41).
  
  
  CONCLUSIONS
  In our study, short-term outcomes of robotic surgery for rectal cancer after CRT were similar to those of laparoscopic surgery in respect to bowel function recovery, morbidity, and TME quality. Well-designed clinical trials are needed to evaluate the functional results and long-term outcomes of robotic surgery for rectal cancer.
authors.affiliation: Center for Colorectal Cancer, National Cancer Center, Goyang, Korea.
authors.forename: Yong Sok
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Center for Colorectal Cancer, National Cancer Center, Goyang, Korea.
authors.forename: Min Jung
authors.initials: MJ
authors.lastname: Kim
authors.affiliation: Center for Colorectal Cancer, National Cancer Center, Goyang, Korea.
authors.forename: Sung Chan
authors.initials: SC
authors.lastname: Park
authors.affiliation: Center for Colorectal Cancer, National Cancer Center, Goyang, Korea.
authors.forename: Dae Kyung
authors.initials: DK
authors.lastname: Sohn
authors.affiliation: Center for Colorectal Cancer, National Cancer Center, Goyang, Korea.
authors.forename: Dae Yong
authors.initials: DY
authors.lastname: Kim
authors.affiliation: Center for Colorectal Cancer, National Cancer Center, Goyang, Korea.
authors.forename: Hee Jin
authors.initials: HJ
authors.lastname: Chang
authors.affiliation: Biometric Research Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
authors.forename: Byung-Ho
authors.initials: BH
authors.lastname: Nam
authors.affiliation: Center for Colorectal Cancer, National Cancer Center, Goyang, Korea.
authors.forename: Jae Hwan
authors.initials: JH
authors.lastname: Oh
mesh_terms: D059248:Chemoradiotherapy; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012004:Rectal Neoplasms / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy*; D065287:Robotic Surgical Procedures; D016896:Treatment Outcome
keywords: Laparoscopy; Rectal neoplasms; Robotic surgical procedures