Robotic-assisted laparoscopic versus open lateral lymph node dissection for advanced lower rectal cancer

Yamaguchi, Takashi; Kinugasa, Yusuke; Shiomi, Akio; Tomioka, Hiroyuki; Kagawa, Hiroyasu

doi:10.1007/s00464-015-4266-y

Cited by 73 publications

(60 citation statements)

References 25 publications

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“…After these procedures, post‐operative urogenital function outcomes are acceptable . In addition, a minimally invasive procedure also contributes to improving long‐term urogenital function . In the current study, only two patients (4.7%) experienced urinary retention, and they needed an indwelling catheter for 1 year.…”

Section: Discussionmentioning

confidence: 52%

“…16,17 In addition, a minimally invasive procedure also contributes to improving long-term urogenital function. 18 In the current study, only two patients (4.7%) experienced urinary retention, and they needed an indwelling catheter for 1 year. These acceptable functional results might be attributable to the nerve-sparing techniques and the extent of LLND.…”

Section: Discussionmentioning

confidence: 55%

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Is laparoscopic selective lateral lymph node dissection for locally advanced rectal cancer after neoadjuvant chemoradiotherapy safe?

Yang

et al. 2019

ANZ Journal of Surgery

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Background This study aimed to evaluate the technical feasibility, safety and oncological outcomes of laparoscopic total mesorectal excision (TME) with selective lateral lymph node (LLN) dissection (sLLND) in patients with locally advanced rectal cancer (LARC) and clinically suspected swollen LLNs treated with preoperative neoadjuvant chemoradiotherapy (nCRT). Methods Consecutive patients with LARC and swollen LLNs who underwent laparoscopic TME and sLLND following nCRT between October 2012 and October 2018 were reviewed from the prospectively collected database. Patient demographics, operation safety, perioperative complications and oncological outcomes were analysed. Results A total of 43 patients were identified. All procedures were completed under laparoscopy without conversion to open surgery. The median operation time was 313 min (range 170–570 min). The median blood loss was 80 mL (range 30–450 mL). The median number of LLNs harvested was 11 (range 1–29). LLN metastasis was found in 12 patients (27.9%). Major post‐operative complications were found in four patients (9.3%). The median hospital stay was 7 days (range 4–27 days). The median time to tolerance to liquid food was 72 h (range 36–120 h). The post‐operative 30‐day mortality rate was 0%. Over the median follow‐up of 24 months, no lateral pelvic recurrence developed. For the whole group of patients, the 2‐year cumulative overall survival and disease‐free survival were 90.5% and 78.1%, respectively. Conclusion With the advantages of a minimally invasive approach, laparoscopic TME and sLLND following preoperative nCRT in patients with LARC and swollen LLNs is safe and feasible. This procedure provides acceptable perioperative and oncological outcomes.

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Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 55%

Is laparoscopic selective lateral lymph node dissection for locally advanced rectal cancer after neoadjuvant chemoradiotherapy safe?

Yang

et al. 2019

ANZ Journal of Surgery

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“…Our result showed that palpation diagnosis of LN metastasis was unreliable. However, previous studies reported that laparoscopic surgery for colorectal cancer can achieve an LN harvest equal to that achieved by open surgery (20)(21)(22). Therefore, neither laparoscopic nor robotic surgery is inferior to open surgery in terms of LN dissection.…”

Section: Discussionmentioning

confidence: 98%

Is it important to palpate lymph nodes in open surgery for colorectal cancer?

Yamaoka

Kinugasa

Shiomi

et al. 2016

Asian J Endoscop Surgery

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“…The docking and separation procedure for a robotic cart is known to be time‐consuming. However, operative times can be decreased if the robotic arms are positioned and the forceps are manipulated in a manner than avoids collisions . In addition, improvements to the robotic system itself, such as da Vinci Xi, will reduce repeated docking, which may result in shorter operative times.…”

Section: Intraoperative Outcomesmentioning

confidence: 99%

“…In contrast, robotic LLND is considered easier to perform because of its stable magnified view and multi‐articulated forceps . Yamaguchi et al reported that robotic LLND was superior to open surgery because of the lower rate of urinary retention .…”

Section: Surgery Beyond Standard Rectal Surgerymentioning

confidence: 99%

Robotic surgery for rectal cancer

Nozawa

Watanabe

2017

Asian J Endoscop Surgery

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Laparoscopic surgery has gained acceptance as a less invasive approach in the treatment of colon cancer. However, laparoscopic surgery for rectal cancer, particularly cancer of the lower rectum, is still challenging because of limited accessibility. Robotic surgery overcomes the limitations of laparoscopy associated with anatomy and offers certain advantages, including 3-D imaging, dexterity and ambidextrous capability, lack of tremors, motion scaling, and a short learning curve. Robotic rectal surgery has been reported to reduce conversion rates, particularly in low anterior resection, but it is associated with longer operative times than the conventional laparoscopic approach. Postoperative morbidities are similar between the robotic and conventional laparoscopic approaches, and oncological outcomes such as the quality of the mesorectum and the status of resection margins are also equivalent. The possible superiority of robotic surgery in terms of the preservation of autonomic function has yet to be established in research based on larger numbers of patients. Although robotic rectal surgery is safe, feasible, and appears to overcome some of the technical limitations associated with conventional laparoscopic surgery, the advantages provided by this technical innovation are currently limited. To justify its expensive cost, robotic surgery is more suitable for select patients, such as obese patients, men, those with cancer of the lower rectum, and those receiving preoperative chemoradiotherapy.

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Robotic-assisted laparoscopic versus open lateral lymph node dissection for advanced lower rectal cancer

Abstract: The short-term outcomes of RALLD may be superior to those of OLLD for advanced lower rectal cancer.

Cited by 73 publications

References 25 publications

Is laparoscopic selective lateral lymph node dissection for locally advanced rectal cancer after neoadjuvant chemoradiotherapy safe?

Is laparoscopic selective lateral lymph node dissection for locally advanced rectal cancer after neoadjuvant chemoradiotherapy safe?

Is it important to palpate lymph nodes in open surgery for colorectal cancer?

Robotic surgery for rectal cancer

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