Technical, functional, and oncological validity of robot-assisted total-intersphincteric resection (T-ISR) for lower rectal cancer

Kim, Jin Cheon; Lee, Jong Lyul; Kim, Chan Wook; Kim, Jung Rang; Kim, Jihun

doi:10.1016/j.ejso.2022.07.010

Cited by 2 publications

(2 citation statements)

References 36 publications

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“…The absence of correlation of ARM with the incontinence score, however, was unexpected. Prior studies have shown that ARM and incontinence measured on various scales are in agreement when carried out at the same time without formal concordance testing [5, 8]. Interestingly, a small study found no correlation between ARM and Wexner scores at 4 months after surgery [9].…”

Section: Discussionmentioning

confidence: 99%

Should anorectal manometry be routine before stoma reversal in patients after an intersphincteric resection?

et al. 2023

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IntroductionAnorectal manometry (ARM) is sometimes performed before ostomy reversal in patients with an intersphincteric resection (ISR) to predict bowel function. However, no clinical predictive data exist regarding its utility.MethodsThe single‐centre, retrospective data of ISR patients who had an ARM prior to ostomy reversal, and bowel functional assessment with the low anterior resection syndrome (LARS) and Wexner incontinence scores at least 6 months after reversal, were considered. Correlation statistics were performed with each of the manometric parameters and functional outcome categories.ResultsEighty‐nine patients were included. The median basal and squeeze pressures were 41 and 100 mmHg, respectively. Any LARS (score ≥20) and major incontinence (score ≥11) was observed in 51.7% and 16.9%, respectively. None of the manometric parameters (median basal or maximum squeeze pressure, anal canal length, volume at urge and the ability to expel) correlated with LARS or incontinence.ConclusionsAnorectal manometry (ARM) before ostomy reversal to predict bowel function at 6 months or beyond was not helpful in patients with an ISR and diverting stoma. No manometric parameter correlated with the LARS or Wexner incontinence scores.

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Section: Discussionmentioning

confidence: 99%

Should anorectal manometry be routine before stoma reversal in patients after an intersphincteric resection?

et al. 2023

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“…A series of RCTs from various centers worldwide, along with numerous retrospective studies over the past 20 years of clinical practice, have presented unified results of comparable survival outcomes of robot-assisted rectal cancer surgery with laparoscopic surgery (Table 1) [17][18][19][20][21]. Confidence from accumulated experience has led to the adaption of robotic surgery to even more complicated and advanced cases of rectal cancer [22][23][24][25][26].…”

Section: Rectal Cancermentioning

confidence: 99%

Robot-Assisted Colorectal Surgery

Kim¹

2022

Ewha Med J

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Minimally invasive surgery for colorectal disease has now become the standard treatment in Republic of Korea. However, there are limitations to the laparoscopic approach, such as an unstable camera support, a limited range of motion, and poor ergonomics. Recent advances in technology have led to the introduction of robotic surgical systems in colorectal surgery to overcome these shortcomings. Robot-assisted colorectal surgery has clear advantages in many aspects. Surgery involving the rectum benefits the most among colorectal diseases owing to technical difficulties in rectum dissection. The concept of robotic surgery is not different from laparoscopic surgery in that it is a minimally invasive surgery, and abundant research demonstrates comparable results from both modalities for postoperative complications, oncological outcomes, and functional outcomes. However, the cost of robot-assisted surgery limits surgeons to performing robotic surgeries in only selected cases. Improvements regarding cost-effectiveness and more convincing studies that support benefits of robotic surgery are needed to popularize robot-assisted colorectal surgery.

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Technical, functional, and oncological validity of robot-assisted total-intersphincteric resection (T-ISR) for lower rectal cancer

Cited by 2 publications

References 36 publications

Should anorectal manometry be routine before stoma reversal in patients after an intersphincteric resection?

Should anorectal manometry be routine before stoma reversal in patients after an intersphincteric resection?

Robot-Assisted Colorectal Surgery

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