Abstract
Purposes
Several retrospective studies have demonstrated the safety and technical feasibility of robotic-assisted laparoscopic surgery (RALS). The aim of the present study was to clarify the advantages of RALS for rectal cancer by comparing its short-term outcomes with those of conventional laparoscopic surgery (CLS).
Methods
Between April, 2010 and April, 2015, a total of 974 patients underwent proctectomy for rectal cancer. After the exclusion of those who underwent open surgery, high anterior resection, lateral lymph node dissection, or multiple resection, 442 patients were enrolled in this study, including 203 who underwent RALS and 239 who underwent CLS. We compared the short-term outcomes of these two groups.
Results
There was no case of conversion to open surgery in the RALS group, but 8 (3.3 %) cases in the CLS group (p = 0.009). Operative time was not significantly different, but blood loss was significantly less in the RALS group than in the CLS group (p < 0.001). The postoperative hospital stay was shorter in the RALS group than in the CLS group (p < 0.001). The rate of urinary retention was significantly lower in the RALS group than in the CLS group (p = 0.018).
Conclusion
The short-term outcomes in this series provide further evidence that RALS may be superior to CLS for rectal cancer.
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References
Yamamoto S, Inomata M, Katayama H, Mizusawa J, Etoh T, Konishi F, et al. Short-term surgical outcomes from a randomized controlled trial to evaluate laparoscopic and open D3 dissection for stage II/III colon cancer: Japan Clinical Oncology Group Study JCOG 0404. Ann Surg. 2014;260:23–30.
Group TCOoSTS. A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med. 2004;350:2050–9.
Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, et al. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet. 2005;365:1718–26.
Hoffmann H, Ruiz-Schirinzi R, Goldblum D, Dell-Kuster S, Oertli D, Hahnloser D, et al. Impact of examinees’ stereopsis and near visual acuity on laparoscopic virtual reality performance. Surg Today. 2015;45:1280–90.
Pigazzi A, Ellenhorn JD, Ballantyne GH, Paz IB. Robotic-assisted laparoscopic low anterior resection with total mesorectal excision for rectal cancer. Surg Endosc. 2006;20:1521–5.
Kwak JM, Kim SH, Kim J, Son DN, Baek SJ, Cho JS. Robotic vs laparoscopic resection of rectal cancer: short-term outcomes of a case–control study. Dis Colon Rectum. 2011;54:151–6.
Ielpo B, Caruso R, Quijano Y, Duran H, Diaz E, Fabra I, et al. Robotic versus laparoscopic rectal resection: is there any real difference? A comparative single center study. Int J Med Robot. 2014;10:300–5.
Baik SH, Kwon HY, Kim JS, Hur H, Sohn SK, Cho CH, Kim H, et al. Robotic versus laparoscopic low anterior resection of rectal cancer: short-term outcome of a prospective comparative study. Ann Surg Oncol. 2009;16:1480–7.
Park JS, Choi GS, Lim KH, Jang YS, Jun SH. S052: a comparison of robot-assisted, laparoscopic, and open surgery in the treatment of rectal cancer. Surg Endosc. 2011;25:240–8.
D’Annibale A, Pernazza G, Monsellato I, Pende V, Lucandri G, Mazzocchi P, et al. Total mesorectal excision: a comparison of oncological and functional outcomes between robotic and laparoscopic surgery for rectal cancer. Surg Endosc. 2013;27:1887–95.
Kang J, Yoon KJ, Min BS, Hur H, Baik SH, Kim NK, et al. The impact of robotic surgery for mid and low rectal cancer: a case-matched analysis of a 3-arm comparison–open, laparoscopic, and robotic surgery. Ann Surg. 2013;257:95–101.
Park EJ, Cho MS, Baek SJ, Hur H, Min BS, Baik SH, et al. Long-term oncologic outcomes of robotic low anterior resection for rectal cancer: a comparative study with laparoscopic surgery. Ann Surg. 2014;261:129–37.
Watanabe T, Itabashi M, Shimada Y, Tanaka S, Ito Y, Ajioka Y, et al. Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2010 for the treatment of colorectal cancer. Int J Clin Oncol. 2012;17:1–29.
Marijnen CA, Kapiteijn E, van de Velde CJ, Martijn H, Steup WH, Wiggers T, et al. Acute side effects and complications after short-term preoperative radiotherapy combined with total mesorectal excision in primary rectal cancer: report of a multicenter randomized trial. J Clin Oncol. 2002;20:817–25.
Shiomi A, Kinugasa Y, Yamaguchi T, Tomioka H, Kagawa H. Robot-assisted rectal cancer surgery: short-term outcomes for 113 consecutive patients. Int J Colorectal Dis. 2014;29:1105–11.
Kagawa H, Kinugasa Y, Shiomi A, Yamaguchi T, Tsukamoto S, Tomioka H, et al. Robotic-assisted lateral lymph node dissection for lower rectal cancer: short-term outcomes in 50 consecutive patients. Surg Endosc. 2014;29:995–1000.
Kinugasa Y, Murakami G, Suzuki D, Sugihara K. Histological identification of fascial structures posterolateral to the rectum. Br J Surg. 2007;94:620–6.
Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.
Yang Y, Wang F, Zhang P, Shi C, Zou Y, Qin H, et al. Robot-assisted versus conventional laparoscopic surgery for colorectal disease, focusing on rectal cancer: a meta-analysis. Ann Surg Oncol. 2012;19:3727–36.
Memon S, Heriot AG, Murphy DG, Bressel M, Lynch AC. Robotic versus laparoscopic proctectomy for rectal cancer: a meta-analysis. Ann Surg Oncol. 2012;19:2095–101.
Yamaguchi T, Kinugasa Y, Shiomi A, Sato S, Yamakawa Y, Kagawa H, et al. Learning curve for robotic-assisted surgery for rectal cancer: use of the cumulative sum method. Surg Endosc. 2015;29:1679–85.
Kim JY, Kim NK, Lee KY, Hur H, Min BS, Kim JH. A comparative study of voiding and sexual function after total mesorectal excision with autonomic nerve preservation for rectal cancer: laparoscopic versus robotic surgery. Ann Surg Oncol. 2012;19:2485–93.
Luca F, Valvo M, Ghezzi TL, Zuccaro M, Cenciarelli S, Trovato C, et al. Impact of robotic surgery on sexual and urinary functions after fully robotic nerve-sparing total mesorectal excision for rectal cancer. Ann Surg. 2013;257:672–8.
Park SY, Choi GS, Park JS, Kim HJ, Ryuk JP, Yun SH. Urinary and erectile function in men after total mesorectal excision by laparoscopic or robot-assisted methods for the treatment of rectal cancer: a case-matched comparison. World J Surg. 2013;38:1834–42.
Barry MJ, Fowler FJ Jr, O’Leary MP, Bruskewitz RC, Holtgrewe HL, Mebust WK, et al. The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol. 1992;148:1549–57 (discussion 1564).
Yamaguchi T, Kinugasa Y, Shiomi A, Tomioka H, Kagawa H. Robotic-assisted laparoscopic versus open lateral lymph node dissection for advanced lower rectal cancer. Surg Endosc. 2015;. doi:10.1007/s00464-015-4266-y.
Acknowledgments
We thank Shunsuke Tsukamoto for his contribution to the acquisition of data for this study.
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Yamaguchi, T., Kinugasa, Y., Shiomi, A. et al. Robotic-assisted vs. conventional laparoscopic surgery for rectal cancer: short-term outcomes at a single center. Surg Today 46, 957–962 (2016). https://doi.org/10.1007/s00595-015-1266-4
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DOI: https://doi.org/10.1007/s00595-015-1266-4