title: Robotic versus laparoscopic surgery for mid or low rectal cancer in male patients after neoadjuvant chemoradiation therapy: comparison of short-term outcomes.
abstract: The aim of our study was to compare short-term outcomes of robotic and laparoscopic sphincter-saving total mesorectal excision (TME) in male patients with mid-low rectal cancer (RC) after neadjuvant chemoradiotherapy (NCRT). The study was conducted as a retrospective review of a prospectively maintained database, and we analyzed 14 robotic and 65 laparoscopic sphincter saving TME (R-TME and L-TME, respectively) performed by one surgeon between 2005 and 2013. Patient characteristics, perioperative recovery, postoperative complications and and pathology results were compared between the two groups. The patient characteristics did not differ significantly between the two groups. Median operating time was longer in the R-TME than in the L-TME group (182 min versus 140 min). Only two conversions occurred in the L-TME group. No difference was found between groups regarding perioperative recovery and postoperative complication rates. The median number of harvested lymph nodes was higher in the RTME than in the L-TME group (32 versus 23, p = 0.008). The median circumferential margin (CRM) was 10 mm in the R-TME group, 6.5 mm in the L-TME group (p = 0.047. The median distal resection margin (DRM) was 27.5 mm in the R-TME, 15 mm in the L-TME group (p = 0.014). Macroscopic grading of the specimen in the R-TME group was complete in all patients. In the L-TME group, grading was complete in 52 (80%) and incomplete in 13 (20%) cases (p = 0.109). R-TME is a safe and feasible procedure that facilitates performing of TME in male patients with mid-low RC after NCRT.
authors.affiliation: Department of General Surgery, Liv Hospital, Istanbul, Turkey. dr_krserin@hotmail.com.
authors.forename: Kursat Rahmi
authors.initials: KR
authors.lastname: Serin
authors.affiliation: Department of General Surgery, Bulent Ecevit University School of Medicine, Zonguldak, Turkey. faycagultekin@yahoo.com.
authors.forename: Fatma Ayca
authors.initials: FA
authors.lastname: Gultekin
authors.affiliation: Department of General Surgery, Liv Hospital, Istanbul, Turkey. drburcinbatman@yahoo.com.
authors.forename: Burçin
authors.initials: B
authors.lastname: Batman
authors.affiliation: General Surgery Clinic, Konya Training and Research Hospital, Konya, Turkey. serdenay@yahoo.com.
authors.forename: Serden
authors.initials: S
authors.lastname: Ay
authors.affiliation: Department of Pathology, VKV American Hospital, Istanbul, Turkey. ykapran@yahoo.com.
authors.forename: Yersu
authors.initials: Y
authors.lastname: Kapran
authors.affiliation: Department of Medical Oncology, Bilim University School of Medicine, Istanbul, Turkey. sezersaglam@yahoo.com.
authors.forename: Sezer
authors.initials: S
authors.lastname: Saglam
authors.affiliation: Department of General Surgery, Liv Hospital, Istanbul, Turkey. oktarasoglu@yahoo.com.
authors.forename: Oktar
authors.identifier: http://orcid.org/0000-0002-9147-1654
authors.initials: O
authors.lastname: Asoglu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000601:surgery; D059248:Chemoradiotherapy; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D059351:Organ Sparing Treatments / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D011183:Postoperative Complications; D012004:Rectal Neoplasms / Q000628:therapy*; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D016896:Treatment Outcome
keywords: Laparoscopic; Rectum cancer; Robotic; Sphincter-saving procedure; Total mesorectal excision