Short- and medium-term outcome of robot-assisted and traditional laparoscopic rectal resection

JSLS. 2009 Apr-Jun;13(2):176-83.


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.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Digestive System Surgical Procedures / methods*
  • Disease-Free Survival
  • Female
  • Humans
  • Laparoscopy
  • Male
  • Middle Aged
  • Rectal Neoplasms / mortality
  • Rectal Neoplasms / surgery*
  • Rectum / surgery*
  • Robotics*
  • Treatment Outcome