Robotic versus laparoscopic sphincter-saving total mesorectal excision for mid or low rectal cancer in male patients after neoadjuvant chemoradiation therapy: comparison of long-term outcomes

Robotic Surgery for Rectal Cancer and Cost-Effectiveness

“…Although the results in detail might vary depending on the studies, the recent comparative studies between laparoscopic and robotic TME for rectal cancer showed overall comparable clinical outcomes (Table 1). [40][41][42][43][44][45][46][47][48] In 2008, Baik et al 40 reported a pilot randomized controlled study for comparing robotic and laparoscopic tumor-specific mesorectal excision (TSME) with a small population, the results showed that the mean operative time was not significantly different between the two groups (217.1±51.6 vs. 204.3±51.9, p=0.477). According to Park et al 42 and Polat et al 48 , the operative time also reported no difference.…”

“…According to Park et al 42 and Polat et al 48 , the operative time also reported no difference. However, except for those studies, the other studies have shown that robotic rectal surgery not only showed longer operative time, [43][44][45][46][47] but also shorter operative time 41 than laparoscopic rectal surgery. Ramji et al 44 suggested that the learning curve and the familiarity of docking systems are the major factors of difference in operative time.…”

“…The length of hospital stay (LOS) of robotic TME is generally similar or slightly shorter than laparoscopic surgery. [40][41][42][43][44][45][46][47][48] Baik et al 40 presented the mean LOS of robotic rectal surgery was shorter than the laparoscopic approach (6.9±1.3 days vs 8.7 ±1.3 days, p<0.001) in the short-term follow up. Park et al 42 also reported similar results regarding LOS in long-term fol-low up (5.86±1.43 days vs 6.54±2.65 days, p=0.035).…”

“…The complication rates of robotic TME were ranged from 14.3% to 47.6%, while those of laparoscopic TME were ranged from 5.5% to 49.4%. [40][41][42][43][44][45][46][47][48] Meanwhile, according to Baik et al 49 , overall postoperative complication rates of both groups had no statistical difference (10.7 vs 19.3, p=0.202), but, the major complication rate of robotic low anterior resection were significantly lower than that of laparoscopic surgery (5.4 vs 19.3, p=0.025). This study suggested that the lower major complication rate in the robotic surgery group may be associated with a faster start of the diet and shorter length of hospital stay.…”

“…The range of conversion rate of robotic rectal surgery has been reported 0 to 12%. [40][41][42][43][44][45][46][47][48] It is shown that the conversion rate of robotic TME had no statistical difference compared with laparoscopic TME, 40,[43][44][45][46] whereas, several studies suggested that robotic TME had a lower conversion rate than that of laparoscopic TME. 41,42,48 According to the 'Robotic vs Laparoscopic Resection for Rectal Cancer (ROLARR)' randomized controlled trial which published the primary results at JAMA in 2017, there was no significant difference in conversion rates between robotic TME and conventional laparoscopic TME (8.1% vs 12.2%, p=0.16).…”