Robotic vs. laparoscopic intersphincteric resection for low rectal cancer: a case matched study reporting a median of 7-year long-term oncological and functional outcomes

Aliyev, Vusal; Piozzi, Guglielmo Niccolò; Bulut, Alisina; Güven, Koray; Bakir, Barış; Sağlam, Sezer; Göksel, Süha; Asoğlu, Oktar

doi:10.1007/s13304-022-01396-1

Cited by 12 publications

(11 citation statements)

References 39 publications

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“…This, along with the hand‐sewn CAA, may cause functional impairment [49, 50], including faecal, urinary continence and sexual function. The literature concentrates mainly on anorectal function showing functional results with different scoring systems or institutional questionnaires [39, 41, 51–54] making comparison of outcomes difficult. Therefore, the panel saw a need to standardize functional outcome.…”

Section: Discussionmentioning

confidence: 99%

“…RISR was reported to be the most significant parameter for ISR achievement (OR 3.467; 95% CI 2.095–5.738) compared to an open approach [40]. Long‐term oncological studies proved the oncological safety of RISR [41]. The novel da Vinci® Single‐Port System (Intuitive Surgical, Sunnyvale, CA, USA) could further facilitate RISR [42–44].…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, on round 2, 73.1% agreed that a robotic approach (RISR) may increase the chance of achieving ISR successfully. RISR was reported to be the most significant parameter for ISR safety of RISR [41]. The novel da Vinci® Single-Port System (Intuitive Surgical, Sunnyvale, CA, USA) could further facilitate RISR [42][43][44].…”

Section: Surgical Technique Of Isrmentioning

confidence: 99%

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International standardization and optimization group for intersphincteric resection (ISOG‐ISR): modified Delphi consensus on anatomy, definition, indication, surgical technique, specimen description and functional outcome

Piozzi

Khobragade

Aliyev³

et al. 2023

Colorectal Disease

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AimIntersphincteric resection (ISR) is an oncologically complex operation for very low‐lying rectal cancers. Yet, definition, anatomical description, operative indications and operative approaches to ISR are not standardized. The aim of this study was to standardize the definition of ISR by reaching international consensus from the experts in the field. This standardization will allow meaningful comparison in the literature in the future.MethodA modified Delphi approach with three rounds of questionnaire was adopted. A total of 29 international experts from 11 countries were recruited for this study. Six domains with a total of 37 statements were examined, including anatomical definition; definition of intersphincteric dissection, intersphincteric resection (ISR) and ultra‐low anterior resection (uLAR); indication for ISR; surgical technique of ISR; specimen description of ISR; and functional outcome assessment protocol.ResultsThree rounds of questionnaire were performed (response rate 100%, 89.6%, 89.6%). Agreement (≥80%) reached standardization on 36 statements.ConclusionThis study provides an international expert consensus‐based definition and standardization of ISR. This is the first study standardizing terminology and definition of deep pelvis/anal canal anatomy from a surgical point of view. Intersphincteric dissection, ISR and uLAR were specifically defined for precise surgical description. Indication for ISR was determined by the rectal tumour's maximal radial infiltration (T stage) below the levator ani. A new surgical definition of T3isp was reached by consensus to define T3 low rectal tumours infiltrating the intersphincteric plane. A practical flowchart for surgical indication for uLAR/ISR/abdominoperineal resection was developed. A standardized ISR surgical technique and functional outcome assessment protocol was defined.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Surgical Technique Of Isrmentioning

confidence: 99%

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International standardization and optimization group for intersphincteric resection (ISOG‐ISR): modified Delphi consensus on anatomy, definition, indication, surgical technique, specimen description and functional outcome

Piozzi

Khobragade

Aliyev³

et al. 2023

Colorectal Disease

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“…In addition, RDP is T A B L E 1 Robotic versus Laparoscopic distal pancreatectomy for pancreatic adenocarcinoma in obese patients: demographics and preoperative characteristics. Obesity increases technical difficulty in oncological minimally invasive surgery, 8,10 and it is worrisomely increasing in western countries: the actual estimation of patients with a BMI >30 is 41.9% in the US and 23.6%-26.7% in some European countries. 17,18 Since operating these patients has become very frequent, we decided to analyse if the assistance of robotic surgery can be helpful in improving the outcomes of such a difficult surgery.…”

Section: Discussionmentioning

confidence: 99%

Robotic versus laparoscopic distal pancreatectomy for pancreatic adenocarcinoma in obese patients

Ausania,

Landi,

González‐Abós

et al. 2023

Robotics Computer Surgery

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BackgroundRobotic distal pancreatectomy (RDP) is associated with a lower conversion rate and less blood loss than laparoscopic distal pancreatectomy (LDP). LDP has similar oncological outcomes as open surgery in PDAC. The aim of this study was to compare perioperative and oncological outcomes in obese patients with RDP versus LDP for PDAC.Materials and methodsRetrospectively, all obese patients who underwent RDP or LDP for PDAC between 2012 and 2022 at 12 international expert centres were included.Resultsout of 372, 81 patients were included. All baseline features were comparable between the two groups. RDP was associated with decreased blood loss (495mlLDP vs. 188mlRDP; p = 0.003), lower conversion rate (13.5%RDP vs. 36.4%LDP; p = 0.019) and lower rate of Clavien‐Dindo ≥3 complications (13.5%RDP vs. 36.4%LDP; p = 0.019). Overall and disease‐free survival were comparable.ConclusionsIn obese patients with left‐sided PDAC, the robotic approach was associated with improved intraoperative outcomes and fewer severe complications.

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“…Since the introduction of robotic systems in the colorectal field, they have become popular, and many studies have reported their safety and effectiveness, especially in rectal cancer surgery 5 , [15][16][17] . Recently, a new robotic system composed of three 6-mm wristed and elbowed instruments and a three-dimensional high-definition camera, all allocated to a single robotic arm, has enabled single-incision robotic surgery.…”

Section: Discussionmentioning

confidence: 99%

A comparative study on the short‐term clinical outcomes of Da Vinci SP versus Da Vinci Xi for rectal cancer surgery

Alshalawi

Lee

Kim

et al. 2023

Robotics Computer Surgery

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PurposeThe Da Vinci SP robot system was recently introduced, but its safety and feasibility for rectal cancer compared with the currently used robot system have not been reported.MethodsThis was a single‐centre retrospective study. Data from patients who underwent abdominal total mesorectal excision (TME) from October 2015 to October 2022 were analysed. After propensity score matching, the short‐term outcomes were compared.ResultsA total of 56 patient data were analysed. Intersphincteric resection was more common in the SP group (7 cases (25%) vs. 0 case (0%), p = 0.001). The operation time was significantly shorter in SP (184 vs. 227.5 min, p < 0.0001), but the docking time was similar. The postoperative complications were similar. There were no differences in the postoperative pain score and length of hospital stay.ConclusionThe SP robotic system for abdominal TME has acceptable short‐term and is safe and technically feasible.

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Robotic vs. laparoscopic intersphincteric resection for low rectal cancer: a case matched study reporting a median of 7-year long-term oncological and functional outcomes

Cited by 12 publications

References 39 publications

International standardization and optimization group for intersphincteric resection (ISOG‐ISR): modified Delphi consensus on anatomy, definition, indication, surgical technique, specimen description and functional outcome

International standardization and optimization group for intersphincteric resection (ISOG‐ISR): modified Delphi consensus on anatomy, definition, indication, surgical technique, specimen description and functional outcome

Robotic versus laparoscopic distal pancreatectomy for pancreatic adenocarcinoma in obese patients

A comparative study on the short‐term clinical outcomes of Da Vinci SP versus Da Vinci Xi for rectal cancer surgery

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