Short- and long-term outcomes of robotic-assisted laparoscopic surgery for rectal cancer: results of a single high-volume center in Japan

Yamaguchi, Takashi; Kinugasa, Yusuke; Shiomi, Akio; Kagawa, Hiroyasu; Yamakawa, Yushi; Furuatni, Akinobu; Manabe, Shoichi; Yamaoka, Yusuke; Hino, Hitoshi

doi:10.1007/s00384-018-3153-0

Cited by 34 publications

(27 citation statements)

References 34 publications

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“…In Japan, Yamaguchi et al [65] and our group [66] recently reported favorable long-term survival rates with RRS for rectal cancer. Although these results were from single-center, single-arm, retrospective studies, the number of patients was adequate and the patients achieved better longevity at each stage compared with the national registry of patients with cancer of the rectum [67].…”

Section: Long-term Outcomesmentioning

confidence: 84%

Robotic Surgery for Rectal Cancer: Operative Technique and Review of the Literature

Katsuno

Hanai

Masumori

et al. 2020

J Anus Rectum Colon

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The number of patients undergoing robotic surgery for rectal cancer has rapidly increased in Japan, since the government approved the procedure for national insurance coverage in April 2018. Robotic surgery has the potential to overcome some limitations of laparoscopic surgery, especially in the narrow pelvis, providing a three-dimensional view, articulated instruments, and a stable camera platform. Although meta-analyses and randomized controlled trials have failed to demonstrate the superiority of robotic surgery over laparoscopic surgery with respect to the short-term clinical outcomes, the published findings suggest that robotic surgery may be potentially beneficial for patients who are obese, male, or patients undergoing sphincterpreserving surgery for rectal cancer. The safety and feasibility of robotic surgery for lateral lymph node dissection, the standard procedure for locally advanced lower rectal cancer in Japan, have been demonstrated in some retrospective studies. However, additional prospective, randomized trials are required to determine the actual benefits of robotic surgery to ameliorate the urogenital and oncological outcomes. The cost of this approach is a long-standing principal concern. A literature search showed that the cost of robotic surgery for rectal cancer was 1.3-2.5 times higher per patient than that for the laparoscopic approach. We herein describe our surgical technique using a da Vinci Surgical System (S/Si/Xi) with 10 years of experience in performing robotic surgery. We also review current evidence regarding short-term clinical and longterm oncological outcomes, lateral lymph node dissection, and the cost of the procedure.

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Section: Long-term Outcomesmentioning

confidence: 84%

Robotic Surgery for Rectal Cancer: Operative Technique and Review of the Literature

Katsuno

Hanai

Masumori

et al. 2020

J Anus Rectum Colon

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“…En cuanto a los resultados quirúrgicos encontrados en este estudio, el tiempo operatorio medio fue de 266 min, valor que se encuentra dentro del rango reportado en investigaciones previas, que oscila entre 180 a 360 min 10,24,33 . Se registra un mayor tiempo operatorio en la cirugía robótica versus laparoscópica 15 , con una diferencia media de 37,5 a 58 min que se atribuye al docking de la consola, el posicionamiento del instrumental y la curva de aprendizaje 15,33 . No obstante, como en la introducción de toda técnica quirúrgica, se señala que con la mejora de la curva de aprendizaje se reduce el tiempo operatorio a largo plazo 24,27,34 .…”

Section: Resultsunclassified

“…Nuestro hallazgo concuerda con lo presentado en la literatura, en la que se describe una escasa pérdida sanguínea intraoperatoria, además, se señala que esta es igual o relativamente menor en comparación a la cirugía laparoscópica 2,9,11,15,17,19,[23][24][25][26]31,32 . Yamaguchi et al 33 , y Katsuno et al 10 Reintervenciones quirúrgicas* 5 13…”

Section: Resultsunclassified

Resultados quirúrgicos y oncológicos de pacientes operados por cáncer de recto con asistencia robótica

et al. 2021

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Objetivo: Analizar los resultados quirúrgicos y oncológicos de pacientes con adenocarcinoma de recto (AR) operados con asistencia robótica.Materiales y métodos: Cohorte prospectiva entre 2014-2019. Criterios de inclusión: pacientes con AR primario, sometidos a una resección de recto con asistencia robótica con intención curativa. Criterios de exclusión: histología no adenocarcinoma. Evaluación de datos clínico-quirúrgicos. Análisis estadístico descriptivo.Resultados: Se incluyeron 37 pacientes; 20 (54%) fueron hombres y la edad promedio fue 58,7 años. La distancia promedio desde el margen anal al borde distal del tumor fue 6,6 cm (i: 2 - 12 cm). La quimioradioterapia (neoadyuvancia) se indicó en 26 pacientes. La cirugía más frecuente fue la resección anterior baja de recto y el tiempo operatorio promedio fue 266 minutos. Se realizaron dos conversiones a laparotomía. Una o más complicaciones se observaron en 17 (45,9%) pacientes, 9 de ellos fueron Clavien-Dindo III ó IV y se reoperaron 5 pacientes (13%). No hubo transfusiones sanguíneas ni mortalidad post-operatoria. La estancia hospitalaria postoperatoria promedio fue 9,6 días (i: 3 – 34 d). El promedio de linfonodos resecados fue 15 (i 4 - 45). Los márgenes quirúrgicos fueron negativos en todos los pacientes. Se restituyó el tránsito intestinal en 28/32 (87,5%) pacientes. El promedio de seguimiento fue 21 meses (1-56), la sobrevida global y libre de enfermedad fue 100%.Discusión y conclusión: La proctectomía con asistencia robótica ha demostrado ser segura en términos de resultados quirúrgicos tempranos y en criterios oncológicos de la pieza operatoria.

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“…Several current studies show that robotic rectal cancer surgery is feasible and safe in terms of surgical and oncologic results, particularly in technically difficult cases, such as narrow pelvises, distal tumors, and tumors that have been previously treated with radiotherapy and chemotherapy 12‐14 …”

Section: Discussionmentioning

confidence: 99%

“…A study of 551 patients operated by robotic surgery in a single‐center for the treatment of rectal cancer reported a median operating time of 257 min (109–683) and an estimated blood loss of 10 ml (0–823). Another single‐center study from 2015 reported a median operating time of 492 min and an estimated blood loss of 150 ml (20–500 ml) 13,19 …”

Section: Discussionmentioning

confidence: 99%

Robotic rectal surgery: Outcomes of the first 102 totally robotic cases handled using the single‐docking technique in a reference institution

Denadai

Melani²,

Neto

et al. 2020

Journal of Surgical Oncology

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Background and Objective Rectal cancer is often surgically treated, but it is still associated with morbidity rates. Minimally invasive techniques are increasingly being used to reduce complications, and the use of such techniques can be found in the literature. This study aims to report our experience in a reference oncology center. Methods A retrospective cohort study was performed on a prospective database of patients who underwent robotic surgery for rectal cancer using the single‐docking technique from September 2014 to April 2018. Clinical and surgical variables, as well as morbidity and mortality rates, were analyzed. Results One hundred and two patients underwent robotic surgery. Intraoperative complications occurred in six patients (4.9%), and postoperative complications in 24 patients (23.5%), of which anastomotic fistula represented 3.9%. The conversion rate was 1.96%. Two cases (1.9%) faced death within 30 days. The median length of hospitalization was 3 days. The median number of lymph nodes dissected was 15. Clinical and surgical data were correlated with postoperative complications, and no statistically significant differences were found. Conclusion Robotic surgery is a safe and feasible approach to manage rectal cancer. The method presents satisfactory results with regard to the rate of operative complications, conversion rate, oncologic outcomes, and length of hospitalization.

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Short- and long-term outcomes of robotic-assisted laparoscopic surgery for rectal cancer: results of a single high-volume center in Japan

Abstract: Our results suggest that RALS is technically feasible for rectal cancer and has good short- and long-term outcomes.

Cited by 34 publications

References 34 publications

Robotic Surgery for Rectal Cancer: Operative Technique and Review of the Literature

Robotic Surgery for Rectal Cancer: Operative Technique and Review of the Literature

Resultados quirúrgicos y oncológicos de pacientes operados por cáncer de recto con asistencia robótica

Robotic rectal surgery: Outcomes of the first 102 totally robotic cases handled using the single‐docking technique in a reference institution

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