title: Short and long-term outcomes of robotic versus laparoscopic total mesorectal excision for rectal cancer: a case-matched retrospective study.
abstract: The true benefits of robotic surgery are controversial, and whether robotic total mesorectal excision (R-TME) can be justified as a standard treatment for rectal cancer patients needs to be clarified. This case-matched study aimed to compare the postoperative complications and short- and long-term outcomes of R-TME and laparoscopic TME (L-TME) for rectal cancer.Among 1029 patients, we identified 278 rectal cancer patients who underwent R-TME. Propensity score matching was used to match this group with 278 patients who underwent L-TME.The mean follow-up period was similar between both groups (L-TME vs R-TME: 52.5 ± 17.1 vs 51.0 ± 13.1 months, P = 0.253), as were patient characteristics. The operation time was significantly longer in the R-TME group than in the L-TME group (361.6 ± 91.9 vs 272.4 ± 83.8 min; P < 0.001), whereas the conversion rate, length of hospital stay, and recovery of pain and bowel motility were similar between both groups. The rates of circumferential resection margin involvement and early complications were similar between both groups (L-TME vs R-TME: 4.7% vs 5.0%, P = 1.000; and 23.7% vs 25.9%, P = 0.624, respectively), as were the 5-year overall survival, disease-free survival, and local recurrence rates (93.1% vs 92.2%, P = 0.422; 79.6% vs 81.8%, P = 0.538; 3.9% vs 5.9%, P = 0.313, respectively).The oncologic quality, short- and long-term outcomes, and postoperative morbidity in the R-TME group were comparable with those in the L-TME group.
authors: From the Department of Surgery, Division of Colon and Rectal surgery, Yonsei University College of Medicine, Seoul, Korea.
authors: Min Soo
authors: MS
authors: Cho
authors: Se Jin
authors: SJ
authors: Baek
authors: Hyuk
authors: H
authors: Hur
authors: Byung Soh
authors: BS
authors: Min
authors: Seung Hyuk
authors: SH
authors: Baik
authors: Kang Young
authors: KY
authors: Lee
authors: Nam Kyu
authors: NK
authors: Kim
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000368:Aged; D013505:Digestive System Surgical Procedures / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D011183:Postoperative Complications / Q000453:epidemiology; D011184:Postoperative Period; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012371:Robotics / Q000706:statistics & numerical data