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Comparative Study
, 13 (2), 176-83

Short- And Medium-Term Outcome of Robot-Assisted and Traditional Laparoscopic Rectal Resection

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Comparative Study

Short- And Medium-Term Outcome of Robot-Assisted and Traditional Laparoscopic Rectal Resection

Alberto Patriti et al. JSLS.

Abstract

Background: Traditional laparoscopic anterior rectal resection (TLAR) has recently been used for rectal cancer, offering good functional results compared with open anterior resection and resulting in a better postoperative early outcome. However, laparoscopic rectal resection can be technically demanding, especially when a total mesorectal excision is required. The aim of this study was to verify whether robot-assisted anterior rectal resection (RLAR) could overcome limitations of the laparoscopic approach.

Methods: Sixty-six patients with rectal cancer were enrolled in the study. Twenty-nine patients underwent RLAR and 37 TLAR. Groups were matched for age, BMI, sex ratio, ASA status, and TNM stage, and were followed up for a mean time of 12 months.

Results: Robot-assisted laparoscopic rectal resection results in shorter operative time when a total mesorectal excision is performed (165.9+/-10 vs 210+/-37 minutes; P<0.05). The conversion rate is significantly lower for RLAR (P<0.05). Postoperative morbidity was comparable between groups. Overall survival and disease-free survival were comparable between groups, even though a trend towards better disease-free survival in the RLAR group was observed.

Conclusion: RLAR is a safe and feasible procedure that facilitates laparoscopic total mesorectal excision. Randomized clinical trials and longer follow-ups are needed to evaluate a possible influence of RLAR on patient survival.

Figures

Figure 1.
Figure 1.
Trocar position for robot-assisted anterior rectal resection and traditional laparoscopic anterior rectal resection. c: camera port; o1 and o2: operative trocars; a1 and a2: accessory trocars. Robotic trocars are inserted with the “trocar in trocar” technique through trocars o1 and o2. Trocar a2 is not always necessary.
Figure 2.
Figure 2.
Disease-free survival curves. Robot-assisted anterior rectal resection: continuous line. Traditional laparoscopic anterior rectal resection: interrupted line.

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