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Observational Study
, 94 (11), e522

Short and Long-Term Outcomes of Robotic Versus Laparoscopic Total Mesorectal Excision for Rectal Cancer: A Case-Matched Retrospective Study

Observational Study

Short and Long-Term Outcomes of Robotic Versus Laparoscopic Total Mesorectal Excision for Rectal Cancer: A Case-Matched Retrospective Study

Min Soo Cho et al. Medicine (Baltimore).


The true benefits of robotic surgery are controversial, and whether robotic total mesorectal excision (R-TME) can be justified as a standard treatment for rectal cancer patients needs to be clarified. This case-matched study aimed to compare the postoperative complications and short- and long-term outcomes of R-TME and laparoscopic TME (L-TME) for rectal cancer.Among 1029 patients, we identified 278 rectal cancer patients who underwent R-TME. Propensity score matching was used to match this group with 278 patients who underwent L-TME.The mean follow-up period was similar between both groups (L-TME vs R-TME: 52.5 ± 17.1 vs 51.0 ± 13.1 months, P = 0.253), as were patient characteristics. The operation time was significantly longer in the R-TME group than in the L-TME group (361.6 ± 91.9 vs 272.4 ± 83.8 min; P < 0.001), whereas the conversion rate, length of hospital stay, and recovery of pain and bowel motility were similar between both groups. The rates of circumferential resection margin involvement and early complications were similar between both groups (L-TME vs R-TME: 4.7% vs 5.0%, P = 1.000; and 23.7% vs 25.9%, P = 0.624, respectively), as were the 5-year overall survival, disease-free survival, and local recurrence rates (93.1% vs 92.2%, P = 0.422; 79.6% vs 81.8%, P = 0.538; 3.9% vs 5.9%, P = 0.313, respectively).The oncologic quality, short- and long-term outcomes, and postoperative morbidity in the R-TME group were comparable with those in the L-TME group.

Conflict of interest statement

The authors report no conflicts of interest.


Flowchart of patient selection.
A Jitter plot of propensity score and histogram of standardized differences used for assessing the overall propensity score distribution between treatment (R-TME) and control (L-TME) groups. L-TME = laparoscopic total mesorectal excision, R-TME = robotic total mesorectal excision.
(A) 5-year overall survival, (B) disease-specific, (C) disease-free survival, and (D) local recurrence rate between laparoscopic and robotic TME (all P values were not significant). TME = total mesorectal excision.

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