Robotic vs Laparoscopic Resection of Rectal Cancer: Short-Term Outcomes of a Case-Control Study

Kwak, Jungwon; Kim, Seon Hahn; Kim, Jin; Son, Dong Nyoung; Baek, Se Jin; Cho, Jae Sung

doi:10.1007/dcr.0b013e3181fec4fd

Cited by 172 publications

(150 citation statements)

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“…Additionally, RCS may offer an advantage in dissection in the deep pelvis especially in patients who have undergone pre-operative chemotherapy [2,9]. While each surgical method offers some advantages over the other, several studies have demonstrated comparable outcomes between robotic and laparoscopic colorectal surgery for intra-operative morbidity, complication rates, and postoperative recovery [1,9,11,12].…”

Section: Introductionmentioning

confidence: 99%

A Review of the Long-Term Oncologic Outcomes of Robotic Surgery Versus Laparoscopic Surgery for Colorectal Cancer

et al. 2015

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The goal of this review was to compare long-term oncologic outcomes of robotic versus laparoscopic resection of colorectal cancer. A literature search was performed using PubMed, EMBASE, Cochrane, and Medline (2002-2014). Search terms: laparoscopic, robotic, rectal, colon, surgery, oncologic, and outcomes. Studies comparing overall and disease free survival of robotic versus laparoscopic surgery for colorectal cancer were included. Meta-analysis was performed using OpenMeta[Analyst] for Windows 8. Five studies were identified reporting on overall survival, disease free survival, lymph node extraction, and distal and circumferential resection margin. Three hundred and seventeen patients underwent robotic resection and 368 underwent laparoscopic resection, with similar demographics. Operative times were longer with robotic resections, with no difference in estimated blood loss (EBL) or length of stay. The disease stage was distributed similarly in both groups. Similar numbers underwent neoadjuvant therapy. Laparoscopic resection was associated with 3.2 mm larger distal resection margins (p=0.04) and 2.2 more lymph nodes removed (p=0.001), but with equivalent circumferential resection margin status. Disease-free and overall survival was equivalent. Robotic and laparoscopic surgery for colorectal cancer offer comparable overall and disease free survival. Laparoscopic surgery offered a slight advantage in operative time, distal margin, and lymph node yield. Larger, prospective trials are needed to confirm the equivalence of these approaches.

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Section: Introductionmentioning

confidence: 99%

A Review of the Long-Term Oncologic Outcomes of Robotic Surgery Versus Laparoscopic Surgery for Colorectal Cancer

et al. 2015

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“…169,170 Alongside this are decisions about how to undertake a particular operation with the robot, again a decision typically undertaken by the consultant surgeon and again not a one-off decision but one likely to evolve over time. For example, in robot-assisted rectal cancer surgery, there is no standardised technique and the decision has to be made whether to perform it as a hybrid operation or totally robot assisted.…”

Section: A Realist Review Of Stakeholders' Theoriesmentioning

confidence: 99%

“…171,176 Yet others pointed to a longer operative time, perceived as being due to collisions of the robotic arms, itself a consequence of lack of experience with proper positioning of the robotic ports. 169 It has also been argued that longer operation duration is related to the lack of tactile information, leading surgeons to move more slowly because they have to rely on visual information only. 177 However, one study found no difference in overall duration because, although the set-up time was significantly longer, this was balanced out by a significantly shorter operative time, which the authors argued was due to the technical advantages that the robot provides to the surgeon.…”

Section: A Realist Review Of Stakeholders' Theoriesmentioning

confidence: 99%

A realist process evaluation of robot-assisted surgery: integration into routine practice and impacts on communication, collaboration and decision-making

Randell

Honey

Hindmarsh

et al. 2017

Health Serv Deliv Res

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Health Services and Delivery ResearchISSN 2050-4349 (Print) ISSN 2050-4357 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: journals.library@nihr.ac.ukThe full HS&DR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hsdr. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Services and Delivery Research journalReports are published in Health Services and Delivery Research (HS&DR) if (1) they have resulted from work for the HS&DR programme or programmes which preceded the HS&DR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. HS&DR programmeThe Health Services and Delivery Research (HS&DR) programme, part of the National Institute for Health Research (NIHR), was established to fund a broad range of research. It combines the strengths and contributions of two previous NIHR research programmes: the Health Services Research (HSR) programme and the Service Delivery and Organisation (SDO) programme, which were merged in January 2012.The HS&DR programme aims to produce rigorous and relevant evidence on the quality, access and organisation of health services including costs and outcomes, as well as research on implementation. The programme will enhance the strategic focus on research that matters to the NHS and is keen to support ambitious evaluative research to improve health services.For more information about the HS&DR programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hsdr This reportThe research reported in this issue of the journal was funded by the HS&DR programme or one of its preceding programmes as project number 12/5005/04. The contractual start date was in September 2013. The final report began editorial review in September 2016 and was accepted for publication in February 2017. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HS&DR editors and production house have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HS&DR programme or the Department of Health. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, NETSCC, the HS&DR programme or the Department...

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“…[10][11][12][13][14][15][16][17][18][19] Prior studies have demonstrated that robotic surgery is feasible and safe 7,[11][12][13][14][15][16][17][18]20,21 but may be associated with higher cost and longer operative duration, particularly for rectal resections. 10,25 Given the single-centre reporting bias present in much of the literature, there is a need for research using multi-institutional data.…”

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confidence: 99%

Comparison of robotic and laparoscopic colorectal resections with respect to 30-day perioperative morbidity

Feinberg

Elnahas

Bashir

et al. 2016

cjs

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Background: Robotic surgery has emerged as a minimally invasive alternative to traditional laparoscopy. Robotic surgery addresses many of the technical and ergonomic limitations of laparoscopic surgery, but the literature regarding clinical outcomes in colorectal surgery is limited. We sought to compare robotic and laparoscopic colorectal resections with respect to 30-day perioperative outcomes. Methods:The American College of Surgeons National Surgical Quality Improvement Program database was used to identify all patients who underwent robotic or laparoscopic colorectal surgery in 2013. We performed a logistic regression analysis to compare intraoperative variables and 30-day outcomes.Results: There were 8392 patients who underwent laparoscopic colorectal surgery and 472 patients who underwent robotic colorectal surgery. The robotic cohort had a lower incidence of unplanned intraoperative conversion (9.5% v. 13.7%, p = 0.008). There were no significant differences between robotic and laparoscopic surgery with respect to other intraoperative and postoperative outcomes, such as operative duration, length of stay, postoperative ileus, anastomotic leak, venous thromboembolism, wound infection, cardiac complications and pulmonary complications. On multivariable analysis, robotic surgery was protective for unplanned conversion, while male sex, malignancy, Crohn disease and diverticular disease were all associated with open conversion. Conclusion:Robotic colorectal surgery has comparable 30-day perioperative morbidity to laparoscopic surgery and may decrease the rate of intraoperative conversion in select patients.Contexte : La chirurgie robotique est de plus en plus utilisée comme option de rechange peu effractive à la laparoscopie classique. La robotique permet de remédier à bon nombre des restrictions techniques et ergonomiques de la chirurgie laparoscopique, mais peu d'articles font état des résultats cliniques en chirurgie colorectale. Nous avons donc cherché à comparer les 2 techniques de résection colorectale en ce qui concerne les résultats peropératoires dans les 30 jours suivant l'intervention.Méthodes : À l'aide de base de données du National Surgical Quality Improvement Program de l'American College of Surgeons, nous avons recensé tous les patients ayant subi une résection colorectale par chirurgie laparoscopique ou robotique en 2013. Nous avons ensuite mené une analyse de régression logistique pour comparer des variables peropératoires et les résultats après 30 jours.Résultats : En tout, 8392 patients avaient subi une chirurgie colorectale par laparoscopie pendant la période visée, et 472 avaient subi une intervention par chirurgie robotique. Le second groupe avait une incidence plus faible de conversion peropéra-toire imprévue (9,5 % par rapport à 13,7 %; p = 0,008). On n'a relevé aucune différence significative entre les 2 types d'intervention quant aux autres résultats peropératoires et postopératoires, soit la durée de l'intervention, la durée du séjour à l'hôpital et la survenue d'un iléus, d'une fui...

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Robotic vs Laparoscopic Resection of Rectal Cancer: Short-Term Outcomes of a Case-Control Study

Abstract: Robotic rectal cancer resection can be safely performed by experienced laparoscopic surgeons, with acceptable short-term outcomes comparable to those for laparoscopic resection.

Cited by 172 publications

References 21 publications

A Review of the Long-Term Oncologic Outcomes of Robotic Surgery Versus Laparoscopic Surgery for Colorectal Cancer

A Review of the Long-Term Oncologic Outcomes of Robotic Surgery Versus Laparoscopic Surgery for Colorectal Cancer

A realist process evaluation of robot-assisted surgery: integration into routine practice and impacts on communication, collaboration and decision-making

Comparison of robotic and laparoscopic colorectal resections with respect to 30-day perioperative morbidity

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