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Technical feasibility of robotic vs. laparoscopic surgery for locally advanced colorectal cancer invading the urinary bladder

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Abstract

Background

The aim of this study was to determine if robotic surgery can reproduce the technical advantages and oncologic outcomes of laparoscopic surgery for the treatment of locally advanced colorectal cancer invading the urinary bladder.

Methods

We retrospectively reviewed the prospectively maintained data of patients with locally advanced colorectal cancer invading the urinary bladder undergoing robotic or laparoscopic surgery between June 2006 and November 2020. Clinicopathologic features, surgical outcomes, and oncologic efficacy were compared between patient groups of robotic or laparoscopic surgery. All patients underwent surgery with the intent of R0 resection for the primary tumor. Major surgical complications were defined as Clavien–Dindo grade ≥ III. Multivariate regression analysis was performed to identify risk factors.

Results

A total of 41 patients (M:F = 32:9; median age: 63 [42–88] years) were analysed; 32 underwent laparoscopic surgery and 9 underwent robotic surgery. There was no statistically significant difference between the two groups in baseline demographic and clinicopathologic features. There were no significant differences in terms of mean operative time (353.24 vs. 387.33 min), mean blood loss (315.00 vs. 171.11 mL), mean number of lymph nodes harvested (27.16 vs. 23.50), R0 resection (89.7 vs. 66.7%), conversion (12.5 vs. 11.1%), major complication rate (9.4 vs. 22.2%), mean time to flatus passage (4.8 vs. 4.1 days), mean postoperative length of hospital stay (18.9 vs. 19.8 days), 5-year disease-free survival rate (64.6 vs. 62.5%) and overall survival rate (75.3 vs. 83.3%). Multivariate analysis showed that R1 resection was the only independent prognostic factor for reduced disease-free survival (hazard ratio 21.386; 95% confidence interval 1.991–229.723; p = 0.0115).

Conclusions

Robotic surgery can reproduce the technical advantages and oncologic outcomes of laparoscopic surgery for the treatment of locally advanced colorectal cancer invading the urinary bladder. However, larger studies are mandatory to clarify the role of robotic surgery in such a scenario.

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Acknowledgements

The authors acknowledge the statistical assistance provided by the Center of Statistical Consultation and Research, Department of Medical Research, National Taiwan University Hospital.

Funding

No funds, grants, or other support was received.

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Authors and Affiliations

  1. Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China

    Yu-Tso Liao

  2. Division of Colorectal Surgery, Department of Surgery, National Taiwan University Hospital, Hsin-chu branch, Hsinchu, Taiwan, Republic of China

    Yu-Tso Liao

  3. Division of Colorectal Surgery, Department of Surgery, National Taiwan University Hospital and College of Medicine, No. 7 Chung-Shan South Road, Taipei, Taiwan, Republic of China

    John Huang, Tzu-Chun Chen, Ji-Shiang Hung & Jin-Tung Liang

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  1. Yu-Tso Liao
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  2. John Huang
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  3. Tzu-Chun Chen
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  4. Ji-Shiang Hung
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  5. Jin-Tung Liang
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Contributions

J-TL conceived and designed the study. Y-TL and T-CC collected the data. Y-TL performed data analysis and wrote the manuscript. J-TL, JH, and J-SH critically revised the manuscript.

Corresponding author

Correspondence to Jin-Tung Liang.

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Conflict of interest

We certify that the authors of this article have no commercial associations that might pose a conflict of interest with regard to the submitted manuscript. The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

The study protocol was approved by the institutional review board of NTUH (202106089RIND). The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

Informed consent was waived due to the retrospective nature of the study.

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Liao, YT., Huang, J., Chen, TC. et al. Technical feasibility of robotic vs. laparoscopic surgery for locally advanced colorectal cancer invading the urinary bladder. Tech Coloproctol 26, 905–914 (2022). https://doi.org/10.1007/s10151-022-02670-5

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  • DOI: https://doi.org/10.1007/s10151-022-02670-5

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