Oncological Outcomes After Robotic Proctectomy for Rectal Cancer

Sammour, Tarik; Malakorn, Songphol; Bednarski, Brian Keith; Kaur, Harmeet; Shin, Ui Sup; Messick, Craig A.; You, Yi Qian Nancy; Chang, George J.

doi:10.1097/sla.0000000000002112

Cited by 44 publications

(31 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…D'Annibale et al [25] documented CRM positivity in none of the patients who underwent robot-assisted proctectomy as compared to the laparoscopic approach. Similar results were also achieved in one of the largest case series on RRR [26], where CRM positivity had an incidence of 2.6%. A further confirmation was also given by a comparative meta-analysis (robot-assisted vs laparoscopic rectal resection) conducted by Xiong et al [27], which demonstrated a significant superiority of the robotic approach in achieving CRM negativity.…”

Section: Discussionsupporting

confidence: 83%

Robotic rectal resection: oncologic outcomes

et al. 2020

View full text Add to dashboard Cite

Robotic surgery has progressively gained popularity in the treatment of rectal cancer. However, only a few studies on its oncologic effectiveness are currently present, with contrasting results. The purpose of this study is to report a single surgeon’s experience on robotic rectal resection (RRR) for cancer, focusing on the analysis of oncologic outcomes, both in terms of pathological features and long-term results. One-hundred and twenty-two consecutive patients who underwent RRR for rectal cancer from January 2013 to December 2019 were retrospectively enrolled. Patients’ characteristics and perioperative outcomes were collected. The analyzed oncologic outcomes were pathological features [distal (DM), circumferential margin (CRM) status and quality of mesorectal excision (TME)] and long-term outcomes [overall (OS) and disease-free survival (DFS)]. The mean operative time was 275 (± 60.5) minutes. Conversion rate was 6.6%. Complications occurred in 27 cases (22.1%) and reoperation was needed in 2 patients (1.5%). The median follow-up was 30.5 (5.9–86.1) months. None presented DM positivity. CRM positivity was 2.5% (2 cases) while a complete TME was reached in 94.3% of cases (115 patients). Recurrence rate was 5.7% (2 local, 4 distant and 1 local plus distant tumor relapse). OS and DFS were 90.7% and 83%, respectively. At the multivariate analysis, both CRM positivity and near complete/incomplete TME were recognized as negative prognostic factors for OS and DFS. Under appropriate logistic and operative conditions, robotic surgery for rectal cancer proves to be oncologically effective, with adequate pathological results and long-term outcomes. It also offers acceptable peri-operative outcomes, further confirming the safety and feasibility of the technique.

show abstract

Section: Discussionsupporting

confidence: 83%

Robotic rectal resection: oncologic outcomes

et al. 2020

View full text Add to dashboard Cite

show abstract

“…No robust evidence of the benefit of RALS over CLS in terms of postoperative complications has yet been established. Anastomotic leakage reportedly occurred in 1.5%–12.2% of patients undergoing RALS and in 2.9%–10.8% of those undergoing CLS in a large cohort study including >200 RALS procedures …”

Section: Short‐term Outcomesmentioning

confidence: 99%

Robotic‐assisted surgery for rectal cancer: Current state and future perspective

Matsuyama

Kinugasa

Nakajima

et al. 2018

Annals of Gastroent Surgery

View full text Add to dashboard Cite

Interest in minimally invasive surgery has increased in recent decades. Robotic‐assisted laparoscopic surgery (RALS) was introduced as the latest advance in minimally invasive surgery. RALS has the potential to provide better clinical outcomes in rectal cancer surgery, allowing for precise dissection in the narrow pelvic space. In addition, RALS represents an important advancement in surgical education with respect to use of the dual‐console robotic surgery system. Because the public health insurance systems in Japan have covered the cost of RALS for rectal cancer since April 2018, RALS has been attracting increasingly more attention. Although no overall robust evidence has yet shown that RALS is superior to laparoscopic or open surgery, the current evidence supports the notion that technically demanding subgroups (patients with obesity, male patients, and patients treated by extended procedures) may benefit from RALS. Technological innovation is a constantly evolving field. Several companies have been developing new robotic systems that incorporate new technology. This competition among companies in the development of such systems is anticipated to lead to further improvements in patient outcomes as well as drive down the cost of RALS, which is one main concern of this new technique.

show abstract

“…[10]. Furthermore, regarding oncological outcomes of RRR, based on evidence from a limited number of cases and initial experiences, substantive data are still lacking [11]. Few centers worldwide have the capacity to perform real world large-scale studies of RRR because of low-volume sample sizes.…”

Section: And Other Interventional Techniquesmentioning

confidence: 99%

Short-term and long-term outcomes of robotic rectal surgery—from the real word data of 1145 consecutive cases in China

Chang

et al. 2019

Surg Endosc

View full text Add to dashboard Cite

Background Due to a limited patient sample size, substantial data on robotic rectal resection (RRR) is lacking. Here, we reported a large consecutive cases from the real word data to assess the safety and efficacy of RRR. Methods From September 2010 to June 2017, a total of 1145 consecutive RRR procedures were performed in patients with stage I-IV disease. We conducted an analysis based on information from a prospectively designed database to evaluate surgical outcomes, urogenital function, and long-term oncological outcomes. Results Of three types of RRR performed, 227 (24.2%) were abdominoperineal resections, 865 (75.5%) were anterior resections, and 3 (0.3%) were Hartmann. Conversion to an open procedure occurred in 5.9% of patients. The overall positive circumferential margin rate was 1.3%. Surgical complication rate and mortality were 16.2% and 0.8% within 30 days of surgery, respectively. Mean hospital stay after surgery and hospital cost were 6.3 ± 2.9 days and 10442.5 ± 3321.5 US dollars, respectively. Risk factors for surgical complications included male gender, tumor location (mid-low rectum), combined organ resection, and clinical T category (cT3-4). Urinary function and general sexual satisfaction decreased significantly 1 month after surgery for both sexes. Subsequently, both parameters increased progressively, and the values 1 year after surgery were comparable to those measured before surgery. At a median follow-up of 34.6 months, local recurrence and distant metastases occurred in 2.3% and 21.1% of patients, respectively. Conclusions Robotic rectal resection was safe with preserved urogenital function and arrived equivalent oncological outcomes in a nonselected group of patients with rectal cancer.

show abstract

Oncological Outcomes After Robotic Proctectomy for Rectal Cancer

Abstract: Robotic proctectomy for rectal cancer can be performed with good short and medium term oncological outcomes in selected patients.

Cited by 44 publications

References 27 publications

Robotic rectal resection: oncologic outcomes

Robotic rectal resection: oncologic outcomes

Robotic‐assisted surgery for rectal cancer: Current state and future perspective

Short-term and long-term outcomes of robotic rectal surgery—from the real word data of 1145 consecutive cases in China

Contact Info

Product

Resources

About