The effect of surgical approach on short-term oncologic outcomes in rectal cancer surgery

Midura, Emily F.; Hanseman, Dennis J.; Hoehn, Richard S.; Davis, Bradley R.; Abbott, Daniel E.; Shah, Shimul A.; Paquette, Ian M.

doi:10.1016/j.surg.2015.02.020

Cited by 20 publications

(10 citation statements)

References 23 publications

(30 reference statements)

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“…The study reported shorter hospital stay, zero conversion rate, and higher lymph node yield with the robotic approach (75). In real-world evidence studies, robotic-assisted surgery vs. open has demonstrated longer surgery times, but shorter hospital stays as well as lower blood loss and comparable rates of anastomotic leaks (76)(77)(78).…”

Section: Q8: Which Is the Most Optimal Technique (Open Or Laparoscopi...mentioning

confidence: 99%

Clinical Robotic Surgery Association (India Chapter) and Indian rectal cancer expert group’s practical consensus statements for surgical management of localized and locally advanced rectal cancer

et al. 2022

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IntroductionThere are standard treatment guidelines for the surgical management of rectal cancer, that are advocated by recognized physician societies. But, owing to disparities in access and affordability of various treatment options, there remains an unmet need for personalizing these international guidelines to Indian settings.MethodsClinical Robotic Surgery Association (CRSA) set up the Indian rectal cancer expert group, with a pre-defined selection criterion and comprised of the leading surgical oncologists and gastrointestinal surgeons managing rectal cancer in India. Following the constitution of the expert Group, members identified three areas of focus and 12 clinical questions. A thorough review of the literature was performed, and the evidence was graded as per the levels of evidence by Oxford Centre for Evidence-Based Medicine. The consensus was built using the modified Delphi methodology of consensus development. A consensus statement was accepted only if ≥75% of the experts were in agreement.ResultsUsing the results of the review of the literature and experts’ opinions; the expert group members drafted and agreed on the final consensus statements, and these were classified as “strong or weak”, based on the GRADE framework.ConclusionThe expert group adapted international guidelines for the surgical management of localized and locally advanced rectal cancer to Indian settings. It will be vital to disseminate these to the wider surgical oncologists and gastrointestinal surgeons’ community in India.

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Section: Q8: Which Is the Most Optimal Technique (Open Or Laparoscopi...mentioning

confidence: 99%

Clinical Robotic Surgery Association (India Chapter) and Indian rectal cancer expert group’s practical consensus statements for surgical management of localized and locally advanced rectal cancer

et al. 2022

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“…Robotic colorectal surgery was first described in 2001, and the first robotic TME was reported in 2006, 4,8-11 but adoption of robotics into the colon and rectal surgical armamentarium has been relatively slow; it is used in only 2.8% of minimally invasive colorectal surgery. 12,13 A major reason for this low rate is the expense of robotic surgical systems, which require an initial investment ranging from $1 to $2.5 million for each unit, 14-16 as well as ongoing maintenance and repair, costly consumables, and additional team training.…”

Section: Robotic Colorectal Surgerymentioning

confidence: 99%

“…Adoption of laparoscopy for proctectomy has been even slower, likely because of its technical demands. 13,74-76 TME requires a high degree of precision, which can be challenging using long, nonarticulating instruments available in laparoscopy. Laparoscopic TME is especially difficult in males, patients with very low tumors, and obese patients, as surgical access and exposure are markedly restricted.…”

Section: Robotic Colorectal Surgerymentioning

confidence: 99%

“…36,78 Thus, while laparoscopic TME for rectal cancer is oncologically equivalent to and offers short-term advantages over the open approach, it has not gained widespread acceptance among rectal cancer surgeons. 13,16,41,44,79-85 The superior precision and dexterity of the robotic system gives it a clear advantage over conventional laparoscopy in rectal cancer surgery. 16,86-88 The use of 4 operating arms provides improved retraction, making reliance on a highly skilled assistant less critical, and the robotic instruments’ precise articulation enables the surgeon to follow the contours of the rectum with greater ease.…”

Section: Robotic Colorectal Surgerymentioning

confidence: 99%

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Robotic gastrointestinal surgery

Felder

Ramanathan

Russo

et al. 2018

Current Problems in Surgery

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“…Colorectal surgeons were among the earliest practitioners to widely adopt minimally invasive approaches, and studies in that field have shown decreased complication rates, decreased to time to chemotherapy, and decreased margin positivity for patients with colorectal cancer who underwent minimally invasive surgery as compared to open procedures. 1 - 4 None of these studies demonstrated a significant difference in time to initiation of chemotherapy between patients undergoing robotic or laparoscopic surgery; however, rates of conversion from a minimally invasive approach to an open approach were significantly lower with a robotic approach. 2 , 5 , 6 …”

Section: Introductionmentioning

confidence: 99%

Minimally Invasive Approaches for Surgical Management of Primary Liver Cancers

Beard

Tsung

2017

Cancer Control

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The benefits of minimally invasive approaches in oncologic surgery are increasingly recognized, and laparoscopic liver surgery has become increasingly widespread. In light of the complexity and technical challenges of hepatobiliary procedures, robotic approaches are also employed. The utility, safety, and oncologic integrity of these methods in the management of primary liver cancers are reported. PubMed was used to search the medical literature for studies and articles pertaining to laparoscopic and robotic liver surgery. Studies that particularly addressed hepatocellular carcinoma and cholangiocarcinoma were identified and reviewed. Laparoscopic liver surgery, including for major resections, has been shown to be safe in experienced hands without any compromise of oncologic outcomes for either hepatocellular carcinoma or intrahepatic cholangiocarcinoma. Some studies show improved clinical outcomes including shorter hospital stays and lower complication rates when compared to open surgery, particularly for patients with cirrhosis. Robotic liver surgeries seem to have equally acceptable clinical outcomes; however, there is limited data regarding oncologic integrity and considerable additional expense. Laparoscopic and robotic liver resections are both feasible and safe for the management of primary liver tumors. Future studies should aim to clarify specific indications and optimize applications of these approaches.

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The effect of surgical approach on short-term oncologic outcomes in rectal cancer surgery

Cited by 20 publications

References 23 publications

Clinical Robotic Surgery Association (India Chapter) and Indian rectal cancer expert group’s practical consensus statements for surgical management of localized and locally advanced rectal cancer

Clinical Robotic Surgery Association (India Chapter) and Indian rectal cancer expert group’s practical consensus statements for surgical management of localized and locally advanced rectal cancer

Robotic gastrointestinal surgery

Minimally Invasive Approaches for Surgical Management of Primary Liver Cancers

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