The circumferential resection margins status: A comparison of robotic, laparoscopic and open total mesorectal excision for mid and low rectal cancer

Jesus, José Paulo de; Valadão, Marcus; Araujo, Rodrigo Otavio; Cesar, Daniel; Linhares, Eduardo; Iglesias, Antonio

doi:10.1016/j.ejso.2016.03.002

Cited by 28 publications

(29 citation statements)

References 29 publications

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“…[ 14 , 16 ] However, our result indicated that a similar number of lymph nodes were harvested in the robotic and LPS groups, consistent with previous reports. [ 7 , 13 , 16 , 18 , 19 , 22 , 28 ]…”

Section: Discussionsupporting

confidence: 92%

“…[ 11 , 26 ] In our study, the mean number in both groups was higher than the requirement for accurate pathological staging and was comparable to the reported numbers of 10 to 32 and 11 to 23 for the robotic and laparoscopic groups, respectively, in other studies. [ 3 , 6 – 9 , 11 , 13 , 16 , 18 , 19 , 22 , 26 , 28 ] Considering that the number of lymph nodes may decrease after nCRT, the present findings were even more favorably comparable with previous findings in patients undergoing nCRT. [ 14 , 16 ] However, our result indicated that a similar number of lymph nodes were harvested in the robotic and LPS groups, consistent with previous reports.…”

Section: Discussionsupporting

confidence: 90%

“…[ 3 , 6 – 9 , 11 , 13 , 16 , 18 , 19 , 22 , 26 , 28 ] Considering that the number of lymph nodes may decrease after nCRT, the present findings were even more favorably comparable with previous findings in patients undergoing nCRT. [ 14 , 16 ] However, our result indicated that a similar number of lymph nodes were harvested in the robotic and LPS groups, consistent with previous reports. [ 7 , 13 , 16 , 18 , 19 , 22 , 28 ]…”

Section: Discussionsupporting

confidence: 90%

“…[ 2 – 4 , 13 , 19 , 22 ] Moreover, when focusing on the subgroup of patients with advanced rectal cancer undergoing nCRT, the rate in our study was favorably comparable with the reported rates of 7.1% to 16.4% and 4.6% to 16% for robotic and laparoscopic surgery, respectively, in previous studies. [ 11 , 16 ] However, we did not observe a higher CRM clearance rate in the robotic group, as many reports did. A study proposed that the higher CRM positive rate might reflect the greater technical difficulty associated with laparoscopic rectal resection.…”

Section: Discussioncontrasting

confidence: 48%

“…[ 5 , 14 , 15 ] Other studies have specified that robotic surgery for rectal cancer results in more favorable outcomes in patients with unfavorable clinical characteristics, such as obesity, male sex, receiving nCRT, and tumors in the lower two-thirds of the rectum. [ 13 , 16 ] However, no solid evidence demonstrating the superiority of the robotic procedure over the conventional laparoscopic procedure is available to support its general adoption for rectal surgery, particularly considering its high cost. [ 17 – 19 ]…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Outcomes of robotic versus laparoscopic surgery for mid and low rectal cancer after neoadjuvant chemoradiation therapy and the effect of learning curve

Huang

Wei

2017

Medicine

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Randomized controlled trials have demonstrated that laparoscopic surgery for rectal cancer is safe and can accelerate recovery without compromising oncological outcomes. However, such a surgery is technically demanding, limiting its application in nonspecialized centers. The operational features of a robotic system may facilitate overcoming this limitation. Studies have reported the potential advantages of robotic surgery. However, only a few of them have featured the application of this surgery in patients with advanced rectal cancer undergoing neoadjuvant chemoradiation therapy (nCRT).From January 2012 to April 2015, after undergoing nCRT, 40 patients with mid or low rectal cancer were operated using the robotic approach at our institution. Another 38 patients who were operated using the conventional laparoscopic approach were matched to patients in the robotic group by sex, age, the body mass index, and procedure. All operations were performed by a single surgical team. The clinicopathological characteristics and short-term outcomes of these patients were compared. To assess the effect of the learning curve on the outcomes, patients in the robotic group were further subdivided into 2 groups according to the sequential order of their procedures, with an equal number of patients in each group. Their outcome measures were compared.The robotic and laparoscopic groups were comparable with regard to pretreatment characteristics, rectal resection type, and pathological examination result. After undergoing nCRT, more patients in the robotic group exhibited clinically advanced diseases. The complication rate was similar between the 2 groups. The operation time and the time to the resumption of a soft diet were significantly prolonged in the robotic group. Further analysis revealed that the difference was mainly observed in the first robotic group. No significant difference was observed between the second robotic and laparoscopic groups.Although the robotic approach may offer potential advantages for rectal surgery, comparable short-term outcomes may be achieved when laparoscopic surgery is performed by experienced surgeons. However, our results suggested a shorter learning curve for robotic surgery for rectal cancer, even in patients who exhibited more advanced disease after undergoing nCRT.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 90%

Section: Discussioncontrasting

confidence: 48%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Outcomes of robotic versus laparoscopic surgery for mid and low rectal cancer after neoadjuvant chemoradiation therapy and the effect of learning curve

Huang

Wei

2017

Medicine

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Brazilian society of surgical oncology: Guidelines for the surgical treatment of mid‐low rectal cancer

Valadão

Cesar

Véo

et al. 2021

Journal of Surgical Oncology

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Background: Colorectal cancer (CRC) is the third leading cause of cancer in North America, Western Europe, and Brazil, and represents an important public health problem. It is estimated that approximately 30% of all the CRC cases correspond to tumors located in the rectum, requiring complex multidisciplinary treatment. In an effort to provide surgeons who treat rectal cancer with the most current information based on the best evidence in the literature, the Brazilian Society of Surgical Oncology (SBCO) has produced the present guidelines for rectal cancer treatment that is focused on the main topics related to daily clinical practice. Objectives:The SBCO developed the present guidelines to provide recommendations on the main topics related to the treatment of mid-low rectal cancer based on current scientific evidence.Methods: Between May and June 2021, 11 experts in CRC surgery met to develop the guidelines for the treatment of mid-low rectal cancer. A total of 22 relevant topics were disseminated among the participants. The methodological quality of a final list with 221 sources was evaluated, all the evidence was examined and revised, and the treatment guideline was formulated by the 11-expert committee. To reach a final consensus, all the topics were reviewed via a videoconference meeting that was attended by all 11 of the experts. Results:The prepared guidelines contained 22 topics considered to be highly relevant in the treatment of mid-low rectal cancer, covering subjects related to the tests required for staging, surgical technique-related aspects, recommended measures to reduce surgical complications, neoadjuvant strategies, and nonoperative treatments. In addition, a checklist was proposed to summarize the important information and offer an updated tool to assist surgeons who treat rectal cancer provide the best care to their patients.

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Testing the Anti-inflammatory Effects of Curcuminoids in Patients with Colorectal Cancer

Jamialahmadi

Guest

Tasbandi

et al. 2021

Methods in Molecular Biology

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The circumferential resection margins status: A comparison of robotic, laparoscopic and open total mesorectal excision for mid and low rectal cancer

Cited by 28 publications

References 29 publications

Outcomes of robotic versus laparoscopic surgery for mid and low rectal cancer after neoadjuvant chemoradiation therapy and the effect of learning curve

Outcomes of robotic versus laparoscopic surgery for mid and low rectal cancer after neoadjuvant chemoradiation therapy and the effect of learning curve

Brazilian society of surgical oncology: Guidelines for the surgical treatment of mid‐low rectal cancer

Testing the Anti-inflammatory Effects of Curcuminoids in Patients with Colorectal Cancer

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