Critical analysis of the literature investigating urogenital function preservation following robotic rectal cancer surgery

Panteleimonitis, Sofoklis; Ahmed, Jamil; Harper, Michael S.; Parvaiz, Amjad

doi:10.4240/wjgs.v8.i11.744

Cited by 25 publications

(17 citation statements)

References 51 publications

(112 reference statements)

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“…They were also concerned about the impact of equipment learning curve on postoperative outcomes because all the procedures were not performed by the same surgical team. Panteleimonitis et al did a critical analysis of currently available evidence of urogenital function following robotic surgery for rectal cancer [ 26 ]. They searched the literature for studies of robotic surgery without conducting a meta-analysis due to great heterogeneity.…”

Section: Discussionmentioning

confidence: 99%

Robotic versus laparoscopic surgery for rectal cancer in male urogenital function preservation, a meta-analysis

Tang

Wang

et al. 2018

World J Surg Onc

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BackgroundUrogenital dysfunction after rectal cancer surgery can largely affect patients’ postoperative quality of life. Whether robotic surgery can be a better option when comparing with laparoscopic surgery is still not well-known.MethodsComprehensive search in PubMed, Embase, Cochrane Library, and Clinical Trials was conducted to identify relevant studies in March 2018. Studies comparing robotic surgery with laparoscopic surgery were included. Measurement of urogenital function was through the International Prostate Symptom Score and International Index of Erectile Function.ResultsSix studies with 386 patients in robotic group and 421 patients in laparoscopic group were finally included. Pooled analysis indicated that bladder function was better at 12 months in the robotic group after the procedures (mean difference, − 0.30, 95% CI, − 0.52 to − 0.08). No significant difference was found at 3 and 6 months postoperatively (mean difference, − 0.37, 95% CI, − 1.48 to 0.73; mean difference, − 1.21, 95% CI, − 2.69 to 0.28). Sexual function was better at 3 months in the robotic group after surgery (mean difference, − 3.28, 95% CI, − 6.08 to − 0.49) and not significantly different at 6 and 12 months. (mean difference, 3.78, 95% CI, − 7.37 to 14.93; mean difference, − 2.82, 95% CI, − 8.43 to 2.80).ConclusionRobotic surgery may offer faster recovery in urogenital function compared to laparoscopic surgery for rectal cancer.

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Section: Discussionmentioning

confidence: 99%

Robotic versus laparoscopic surgery for rectal cancer in male urogenital function preservation, a meta-analysis

Tang

Wang

et al. 2018

World J Surg Onc

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“…Some reports indicate that robotic surgery is a superior technique for patients with rectal cancer. A recent study found that patients had better urogenital function due to preservation of the pelvic nerves following robotic surgery 4) . Postoperative complications in patients with obesity or lower rectal cancer treated at a single institute were also consistently reduced following robotic surgery 5) .…”

Section: Robotic Surgerymentioning

confidence: 99%

Adaptation of robotic surgery for colorectal cancer in a regional university

Maeda

Kobayashi

2017

Ann. Cancer Res. Therap.

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Dear Editor,Robotic surgery to treat colorectal cancer was first used in our regional university at the end of 2014. Staff undertook a comprehensive training program to acquire new techniques required for using this innovative device, composed of online training, onsite training at our institute with the actual robot, off-site training using animal subjects, visiting institutes with the relevant expertise, and pre-operative simulation. By the end of 2016, seven cases had been treated using robotic surgery at our institute. Although the mean operation time (range: 179-464 minutes) is longer than that for laparoscopic surgery in our institute, there have been no cases of open conversion or postoperative complications following robotic surgery. Hence, the use of robotic surgery to treat colorectal cancer in our institute seems feasible so far. However, furtherance of robotic surgery requires solid evidence of this technique's real benefits.Schootman et al recently compared the short-term results of robotic surgery and conventional laparoscopic surgery for treating colon diseases 1) . Data for a total of 2233 robotic and 10 844 conventional laparoscopic surgeries performed between 2013 and 2015 were obtained from the National Surgical Quality Improvement Program (NSQIP). Not surprisingly, the propensity score-matched outcomes revealed that robotic surgery was associated with longer operation times and a lower chance of open conversion. It is likely that the setup for robotic surgery (including docking and undocking) to enable console operation contributed to the extended operation times. In addition, the consequent dexterous surgery theoretically reduced open conversion rates. However, in contrast to general expectations, analysis of postoperative complications revealed that some complications were 3.1% more frequent following robotic surgery. Increases in critical events such as readmission within 30 days of surgery, prolonged ileus, reoperations, and anastomotic leakage are concerning. Many reviews have also discussed the safety and efficacy of robotic surgery in patients with rectal/colorectal cancers 2,3) . Robotic surgery was consistently associated with decreased open conversion rates and longer operation times; however, most of the studies analyzed were retrospective studies. Although it appears that robotic surgery and conventional laparoscopic surgery have similar safety profiles, this alone is not enough to justify the preferential use of robotic surgery, especially considering the higher costs associated with this technique. Some reports indicate that robotic surgery is a superior technique for patients with rectal cancer. A recent study found that patients had better urogenital function due to preservation of the pelvic nerves following robotic surgery 4) . Postoperative complications in patients with obesity or lower rectal cancer treated at a single institute were also consistently reduced following robotic surgery 5) .Overall, the literature suggests that robotic surgery adversely affects the outcomes...

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“…With changes in living habits and diet, the incidence of colon cancer in China has increased substantially, and the incidence rate of colon cancer is double the global average ( 2 – 4 ). Therefore, the effective prevention and treatment of colon cancer has become a focus of medical investigations ( 3 , 5 , 6 ). In addition to traditional surgery, radiotherapy and chemotherapy, the combining of traditional Chinese medicine and Western medicine treatment strategies offer potential in the treatment of the colon cancer ( 7 , 8 ).…”

Section: Introductionmentioning

confidence: 99%

Codonopisï¿½bulleynana Forest ex Diels inhibits autophagy and induces apoptosis of colon cancer cells by activating the NF-κB signaling pathway

Luan

Zhu

et al. 2017

Int J Mol Med

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Despite its favorable clinical efficacy, oxaliplatin-based chemotherapy frequently results in treatment withdrawal and induces liver damage in colon cancer. Therefore, it is important to develop novel drugs, which can safely and effectively complement or replace the therapeutic effects of oxaliplatin. Codonopis bulleynana Forest ex Diels (cbFeD) has wide range of pharmacological effects, including anticancer effects. In the present study, the anticancer activity of cbFeD and its potential molecular mechanisms were investigated. In vitro, cell counting kit-8 assays and flow cytometry were used to assess the anti-proliferation and apoptosis-promoting activities of cbFeD. Transmission electron microscopy was used to monitor the autophagic vesicles. Immunofluorescence staining was performed to observe the nuclear translocation of p65 and the fluorescence of microtubule-associated protein 1 light chain 3 (LC3) B-II. The protein expression levels of p65, inhibitor of nuclear factor (NF)-κB (IκB) a, LC3B-I, LC3B-II and Beclin-1 were detected using western blot analysis. In vivo, the antitumor effect of cbFeD was assessed in colon cancer-bearing nude mice as a model. H&E staining and immunohistochemistry (IHC) were performed, with oxaliplatin set as a positive control. The results showed that cbFeD inhibited cell proliferation and promoted cell apoptosis in a dose-dependent manner. The effects of a high dose of cbFeD on colon cancer cells were similar to those of oxaliplatin. In HCT116 and SW480 cells, cbFeD inhibited the expression of IκBα, LC3B-I/II and Beclin-1, and the results of western blot analysis and immunofluorescence showed that, in the cells treated with cbFeD, p65 gradually entered nuclei in a dose-dependent manner, and the expression of LC3B-II was gradually reduced. The results of the acridine orangestaining and electron microscopy demonstrated fewer autophagic vesicles in the high-dose cbFeD group and the oxaliplatin group. The high dose of cbFeD reversed the effect of pyrrolidine dithiocarbamate, a p65-inhibitor, on the expression of p65, LC3B-I, LC3B-II and Beclin-1, and on the production of autophagic vacuoles. The high dose of cbFeD and oxaliplatin also suppressed tumorigenicity in vivo. The results of the H&E and IHC staining confirmed the inhibition of autophagy (LC3 and Beclin-1) and activation of p65 by treatment with the high dose of cbFeD and oxaliplatin. Taken together, cbFeD exhibited an antitumor effect in colon cancer cells by inhibiting autophagy through activation of the NF-κB pathway. Therefore, cbFeD may be a promising Chinese herbal compound for development for use in cancer therapy.

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Critical analysis of the literature investigating urogenital function preservation following robotic rectal cancer surgery

Cited by 25 publications

References 51 publications

Robotic versus laparoscopic surgery for rectal cancer in male urogenital function preservation, a meta-analysis

Robotic versus laparoscopic surgery for rectal cancer in male urogenital function preservation, a meta-analysis

Adaptation of robotic surgery for colorectal cancer in a regional university

Codonopisï¿½bulleynana Forest ex Diels inhibits autophagy and induces apoptosis of colon cancer cells by activating the NF-κB signaling pathway

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