Short- and medium-term outcome of robot-assisted and traditional laparoscopic rectal resection

Traditional laparoscopic anterior rectal resection (TLAR) has recently been used for rectal cancer, offering good functional results compared with open anterior resection and resulting in a better postoperative early outcome. However, laparoscopic rectal resection can be technically demanding, espec...

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Published inJournal of the Society of Laparoendoscopic Surgeons Vol. 13; no. 2; pp. 176 - 183
Main Authors Patriti, Alberto, Ceccarelli, Graziano, Bartoli, Alberto, Spaziani, Alessandro, Biancafarina, Alessia, Casciola, Luciano
Format Journal Article
LanguageEnglish
Published United States Society of Laparoendoscopic Surgeons 01.04.2009
Subjects
Aged
Digestive System Surgical Procedures - methods
Disease-Free Survival
Female
Humans
Laparoscopy
Male
Middle Aged
Rectal Neoplasms - mortality
Rectal Neoplasms - surgery
Rectum - surgery
Robotics
Scientific Papers
Treatment Outcome
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Summary:Traditional laparoscopic anterior rectal resection (TLAR) has recently been used for rectal cancer, offering good functional results compared with open anterior resection and resulting in a better postoperative early outcome. However, laparoscopic rectal resection can be technically demanding, especially when a total mesorectal excision is required. The aim of this study was to verify whether robot-assisted anterior rectal resection (RLAR) could overcome limitations of the laparoscopic approach. Sixty-six patients with rectal cancer were enrolled in the study. Twenty-nine patients underwent RLAR and 37 TLAR. Groups were matched for age, BMI, sex ratio, ASA status, and TNM stage, and were followed up for a mean time of 12 months. Robot-assisted laparoscopic rectal resection results in shorter operative time when a total mesorectal excision is performed (165.9+/-10 vs 210+/-37 minutes; P<0.05). The conversion rate is significantly lower for RLAR (P<0.05). Postoperative morbidity was comparable between groups. Overall survival and disease-free survival were comparable between groups, even though a trend towards better disease-free survival in the RLAR group was observed. RLAR is a safe and feasible procedure that facilitates laparoscopic total mesorectal excision. Randomized clinical trials and longer follow-ups are needed to evaluate a possible influence of RLAR on patient survival.
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We wish to thank Dr Luigi Maria Lapalorcia for language revision.
ISSN:1086-8089
1938-3797