Robotic male and laparoscopic female sphincter-preserving total mesorectal excision of mid-low rectal cancer share similar specimen quality, complication rates and long-term oncological outcomes

Aliyev, Vusal; Piozzi, Guglielmo Niccolò; Huseynov, Elnur; Mustafayev, Teuta Zoto; Kayku, Vildan; Göksel, Süha; Asoğlu, Oktar

doi:10.1007/s11701-023-01558-2

Cited by 8 publications

(2 citation statements)

References 42 publications

(46 reference statements)

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“…These studies once again demonstrated that robotic approach can potentially overcome some technical challenges related to pelvic anatomical differences between sexes compared to laparoscopy. However, our two previously published studies indicated that robotic approach did not provide any bene t in female patients with rectal cancer when compared with laparoscopy [29][30].…”

Section: Discussionmentioning

confidence: 78%

Perioperative and long-term oncological outcomes of robotic versus laparoscopic total mesorectal excision: a retrospective study of 672 patients

Shadmanov,

Aliyev,

Piozzi

et al. 2024

J Robotic Surg

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BackroundAlthough there's growing information about the long-term oncological effects of robotic surgery for rectal cancer, the procedure is still relatively new. This study aimed to assess the long-term oncological results of total mesorectal excision (TME) performed laparoscopically versus robotically in the setting of rectal cancer. MethodsRestrospective analysis of a prospectively maintained database. A total of 489 laparoscopic (L-TME) and 183 robotic total mesorectal excisions (R-TME) were carried out by a single surgeon between 2013 and 2023. The groups were compared in terms of perioperative and long-term oncological outcomes. ResultsIn the R-TME and L-TME groups, male sex predominated (75.4% and 57.3%, respectively), although the robotic group was signi cantly greater (p = 0.008). There was no conversion in R-TME group, whereas three (0.6%) converted to open surgery in L-TME group. The R-TME group had a statistically signi cant higher number of distal rectal tumors (85%) compared to the L-TME group (54.6%). Only three (1.7%) patients in the R-TME group received abdomineperineal resection (APR); in contrast, 25 (5%) patients in the L-TME group received APR (p < 0.001). For R-TME, the mean follow-up was 70.7 months (range 18-138) and for L-TME, it was 60 months (range 14-140). Frequency of completed mesorectum was signi cantly greater in R-TME group (98.9% vs 94.2%, p < 0.001). The 5-year overall survival rates for R-TME and L-TME groups were 89.6% and 88.7%, respectively. The 5-year disease-free survival for R-TME and L-TME groups were 84.1% and 81.1%, respectively. The local recurrences rates were 7.6% and 6.3%, respectively in R-TME and L-TME groups (p = 0.274). ConclusionR-TME is characterized by no conversion and improved mesorectal integrity. R-TME had longer operation time. The long-term oncological outcomes were comparable between groups.

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Section: Discussionmentioning

confidence: 78%

Perioperative and long-term oncological outcomes of robotic versus laparoscopic total mesorectal excision: a retrospective study of 672 patients

Shadmanov,

Aliyev,

Piozzi

et al. 2024

J Robotic Surg

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“…Recently, it has been proposed that the robotic approach may provide a better mesorectal specimen and local control compared to the laparoscopic technique in male patients with mid-low rectal cancer while the same research group has failed to show these benefits in female patients. [10,11] This suggests the robotic surgery may be superior, especially in the narrow pelvis. However, robotic surgery is expensive and difficult to access; selection criteria for rectal carcinoma cases may increase the benefits and cost-effectiveness of this technique.…”

Section: Discussionmentioning

confidence: 99%

Can 3D radiological calculations predict operational difficulties for rectal cancer?: A single center retrospective analysis

Yasar,

Gundogdu,

Yilmaz

et al. 2024

Medicine

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Low anterior resection, performing total mesorectal excision with appropriate pelvic dissection to prevent local recurrence, is probably the most challenging type of surgery in colorectal surgery, especially in a narrow pelvis. In this study, we aimed to predict the operation difficulty of rectal cancer by comparing the operation time with 2D and 3D pelvimetry. Sixty-six patients who underwent total mesorectal excision after neoadjuvant chemoradiotherapy due to primary rectal cancer located in the middle and lower rectum (10 cm from the anus) were included in the study. Surgery notes were reviewed and data on demographic factors, tumor stage, duration of surgery, and types of surgery were collected, as well as pelvimetric parameters. All protocols had 2D T2-weighted sequences in 3 planes (axial, sagittal, and coronal). Pelvimetric measurements were made by measuring 8 pelvic lengths and 2 angles. Pelvis and tumor volume were measured by manual margin monitoring. In each slice, both pelvis and tumor boundaries were manually drawn individually in the sagittal plane. Pelvis and tumor volumes were calculated from the set of adjacent images by summing slice thickness and products of area measurements within the pelvis and tumor boundaries. In our results, no correlation was observed with operation time, including pelvic volume. Exception for this were interacetabular distance and tumor volume. In the regression test, the only parameter that correlated with the operation time was tumor volume. In conclusion, we believe that tumor volumetric calculations may be useful in predicting difficult distal rectal carcinoma surgeries.

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Robotic and laparoscopic sphincter-saving resections have similar peri-operative, oncological and functional outcomes in female patients with rectal cancer

Aliyev,

Piozzi,

Shadmanov

et al. 2023

Updates Surg

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Robotic male and laparoscopic female sphincter-preserving total mesorectal excision of mid-low rectal cancer share similar specimen quality, complication rates and long-term oncological outcomes

Cited by 8 publications

References 42 publications

Perioperative and long-term oncological outcomes of robotic versus laparoscopic total mesorectal excision: a retrospective study of 672 patients

Perioperative and long-term oncological outcomes of robotic versus laparoscopic total mesorectal excision: a retrospective study of 672 patients

Can 3D radiological calculations predict operational difficulties for rectal cancer?: A single center retrospective analysis

Robotic and laparoscopic sphincter-saving resections have similar peri-operative, oncological and functional outcomes in female patients with rectal cancer

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