Surgical stress response after colorectal resection: a comparison of robotic, laparoscopic, and open surgery

Shibata, Junichi; Ishihara, Soichiro; Tada, Noriko; Kawai, Kazushige; Tsuno, Nelson H.; Yamaguchi, Hironori; Sunami, Eiji; Kitayama, Joji; Watanabe, Toshiaki

doi:10.1007/s10151-014-1263-4

Cited by 44 publications

(45 citation statements)

References 33 publications

(31 reference statements)

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“…Therefore, there appears to be no difference in the degree of surgical stress between robotic and laparoscopic surgeries, which is further corroborated by our recent study evaluating surgical stress using immunological parameters [27]. In this study, the expression of HLA-DR by peripheral blood lymphocytes, which is considered a marker of immune competence, was significantly higher in robotic surgery cases than in open surgery cases, and no difference was found from laparoscopic surgery cases, indicating that robotic and laparoscopic surgery for rectal cancer lead to reduced surgical stress compared with open surgery.…”

Section: Postoperative Recoverysupporting

confidence: 79%

Recent advances in robotic surgery for rectal cancer

et al. 2015

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Robotic technology, which has recently been introduced to the field of surgery, is expected to be useful, particularly in treating rectal cancer where precise manipulation is necessary in the confined pelvic cavity. Robotic surgery overcomes the technical drawbacks inherent to laparoscopic surgery for rectal cancer through the use of multi-articulated flexible tools, three-dimensional stable camera platforms, tremor filtering and motion scaling functions, and greater ergonomic and intuitive device manipulation. Assessments of the feasibility and safety of robotic surgery for rectal cancer have reported similar operation times, blood loss during surgery, rates of postoperative morbidity, and circumferential resection margin involvement when compared with laparoscopic surgery. Furthermore, rates of conversion to open surgery are reportedly lower with increased urinary and male sexual functions in the early postoperative period compared with laparoscopic surgery, demonstrating the technical advantages of robotic surgery for rectal cancer. However, long-term outcomes and the cost-effectiveness of robotic surgery for rectal cancer have not been fully evaluated yet; therefore, large-scale clinical studies are required to evaluate the efficacy of this new technology.

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Section: Postoperative Recoverysupporting

confidence: 79%

Recent advances in robotic surgery for rectal cancer

et al. 2015

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“…La primera es que la técnica laparoscópica facilita al cirujano la visión del campo, mejorando los resultados quirúrgicos 24 , aun a costa de un aumento del tiempo operatorio 21 . La segunda es que existe una disminución en el estrés quirúrgico asociado a la utilización de técnicas de abordaje laparoscópicas, bien robóticas, bien con operador humano, frente a las técnicas de abordaje abierto 25 . Todo ello nos hace pensar en la necesidad de empezar a aplicar técnicas de abordaje laparoscópicas para la realización de cistectomías radicales en nuestra práctica diaria.…”

Section: Discussionunclassified

Impacto de un programa de recuperación intensificada en cistectomía radical. Estudio comparativo de cohortes

Francés

Roberto-Alcácer

García-Lecina

et al. 2017

Revista Española de Anestesiología y Reanimación

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“…Despite the paucity of data, it seems obvious that the surgeons’ overall well-being would benefit from optimization of the surgical environment, which may have an impact on the perceived level of stress, as well as on the surgical performance, ultimately resulting in improved patient outcomes [ 19 ]. However, in the present study, the surgeon’s distress was not assessed by means of truly objective measures (e.g., heart rate, serum levels of stress-related factors [ 20 ]), and thus, further studies are awaited to clarify this facet. Moreover, these results must be interpreted with caution due to the limited sample size and the non-randomized study design (no power analysis), and they cannot be generalized since they describe the initial experience in robotic transverse colectomy of a surgical team accustomed to robotic colorectal surgery [ 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

Initial experience of robotic versus laparoscopic colectomy for transverse colon cancer: a matched case-control study

et al. 2015

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BackgroundRobotic surgery for transverse colon cancer has rarely been described. This study reports our initial experience in robotic resection for transverse colon cancer, by comparing robotic transverse colectomy (RC) to laparoscopic transverse colectomy (LC) in terms of safety, feasibility, short-term outcomes, and the surgeon’s psychological stress and physical pain.MethodsThe study population included the first 22 consecutive patients who underwent RC between March 2013 and December 2014 for histologically confirmed transverse colon adenocarcinoma. These patients were compared with 22 matched patients undergoing LC between December 2010 and February 2013. Patients were matched based on age, gender, body mass index (BMI), American Society of Anesthesiology (ASA) score, American Joint Committee on Cancer (AJCC) tumor stage, and tumor location (ratio 1:1). Mortality, morbidity, operative, and short-term oncologic outcomes were compared between groups. The operating surgeon’s stress and pain were assessed before and after surgery on a 0–100-mm visual analog scale.ResultsThe demographic and preoperative characteristics were comparable between RC and LC patients. No group difference was observed for intraoperative complications, blood loss, postoperative pain, time to flatus, time to regular diet, and hospital stay. RC was associated with longer operative time than LC (260 min vs. 225 min; p = 0.014), but the overall operative and robotic time in the RC group decreased over time reflecting the increasing experience in performing this procedure. No conversion to laparotomy was observed in the RC group, while two LC patients were converted due to uncontrolled bleeding and technically difficult middle colic pedicle dissection. Postoperative complications (Dindo-Clavien grade I or II) occurred in 11.3 % of patients with no group difference. Mortality was nil. All resections were R0, with >12 lymph nodes harvested in 90.9 % of RC and 95.5 % of LC patients. The surgeon’s stress was not different between RC and LC, whereas the surgeon’s hand and neck/shoulder pain were significantly lower after RC.ConclusionsRC for transverse colon cancer appears to be safe and feasible with short-term outcomes comparable to LC.

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Surgical stress response after colorectal resection: a comparison of robotic, laparoscopic, and open surgery

Abstract: Perioperative surgical stress, as evaluated by immunological parameters, was comparable between robotic and laparoscopic surgery and higher with open surgery. Robotic surgery may be an alternative to laparoscopic surgery, as a minimally invasive surgery option for colorectal cancer.

Cited by 44 publications

References 33 publications

Recent advances in robotic surgery for rectal cancer

Recent advances in robotic surgery for rectal cancer

Impacto de un programa de recuperación intensificada en cistectomía radical. Estudio comparativo de cohortes

Initial experience of robotic versus laparoscopic colectomy for transverse colon cancer: a matched case-control study

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