title: Robotic versus laparoscopic rectal resection for sphincter-saving surgery: pathological and short-term outcomes in a single-center analysis of 130 consecutive patients.
abstract: Minimally invasive sphincter-saving rectal resection represents a challenging procedure. Robotic surgery for rectal cancer has several advantages over conventional surgery in performing precise dissection and was proved to be safe and effective in previous studies. However, comparison between laparoscopic and robotic rectal resection has drawn contradictory results. The aim of the present study was to compare robotic and laparoscopic sphincter-saving rectal resections for short-term and pathological outcomes.
  
  
  
  Between January 2013 and May 2016, we performed a total of 258 robotic surgeries, including 146 colorectal resections (56%). For this study, we included the first 65 sphincter-saving robotic resections and compared them to the last 65 consecutive laparoscopic resections. The laparoscopic group was constituted by the last 65 consecutively operated patients who matched the inclusion criteria.
  
  
  
  Patients' baseline characteristics were similar in both the groups. Conversion rate was greater in the laparoscopic group (17 vs. 5%, p=0.044). Reoperation rate, overall and severe morbidity, and median hospital stay were similar in both the groups. Quality of mesorectal excision specimen was considered complete or near complete in 97 and 96% in the laparoscopic and robotic groups, respectively. There was no difference in the rates of negative circumferential radial margin, distal margin, and surgical success measured by composite criteria.
  
  
  
  The main finding of this study was that robotic proctectomy for sphincter-saving procedures offers similar quality of TME with a statistically significant lower rate of conversion when compared to laparoscopic proctectomy.
authors.affiliation: Service de Chirurgie Digestive, Groupe Hospitalier Diaconesses Croix Saint Simon, 125, rue d'Avron, 75020, Paris, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Valverde
authors.affiliation: Service de Chirurgie Digestive, Groupe Hospitalier Diaconesses Croix Saint Simon, 125, rue d'Avron, 75020, Paris, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Goasguen
authors.affiliation: Service de Chirurgie Digestive, Groupe Hospitalier Diaconesses Croix Saint Simon, 125, rue d'Avron, 75020, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Oberlin
authors.affiliation: Service d'Anatomie Pathologique, Hôpital Saint Antoine, Paris, France.|University Paris VI, Paris, France.
authors.forename: Magali
authors.initials: M
authors.lastname: Svrcek
authors.affiliation: Service d'Anatomie Pathologique, Hôpital Saint Antoine, Paris, France.|University Paris VI, Paris, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Fléjou
authors.affiliation: Service de Chirurgie Digestive, Groupe Hospitalier Diaconesses Croix Saint Simon, 125, rue d'Avron, 75020, Paris, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Sezeur
authors.affiliation: Service de Chirurgie Digestive, Groupe Hospitalier Diaconesses Croix Saint Simon, 125, rue d'Avron, 75020, Paris, France.
authors.forename: Henri
authors.initials: H
authors.lastname: Mosnier
authors.affiliation: Service de Chirurgie Digestive, Groupe Hospitalier Diaconesses Croix Saint Simon, 125, rue d'Avron, 75020, Paris, France.
authors.forename: Rémi
authors.initials: R
authors.lastname: Houdart
authors.affiliation: Service de Chirurgie Digestive, Groupe Hospitalier Diaconesses Croix Saint Simon, 125, rue d'Avron, 75020, Paris, France. rmlupinacci@gmail.com.
authors.forename: Renato M
authors.initials: RM
authors.lastname: Lupinacci
mesh_terms: D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000601:surgery; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D012086:Reoperation / Q000706:statistics & numerical data; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
keywords: Laparoscopy; Minimally invasive surgical procedures; Rectal cancer; Robotics