Trattamento chirurgico del cancro del retto con tecnica robotica

risultati a breve termine di uno studio prospettico monocentrico

Translated title of the contribution: Robotic rectal resection in rectal cancer: Short term results in an monocentric prospective study

P. P. Bianchi, W. Petz, G. Spinoglio, D. Belotti, E. Bertani, M. G. Zampino, C. Crosta, R. Lazzari, B. Andreoni

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Aim. The aim of this study was to evaluate technical feasibility, oncological safety and short-term clinical results of robotic rectal resection for cancer. Methods. From January 2008 to July 2010 , 46 patients (27 males and 19 females, median age 69 years, median BMI 24.6 kg/m 2 ) with histologically-proven adenocarcinoma of medium and distal rectum were enrolled in a prospective database. Preoperative assessment was performed with colonoscopy with biopsies, thoraco-abdominal CT scan, pelvic MRI and endorectal-ultrasound (ERUS). In the case of locally advanced non metastatic disease (T3/4 or Nl/2) , patients received preoperative radiotherapy (45 Grays in 5 weeks) and chemotherapy (oral Capecitabine). The robotic system was a four-arms Da Vinci ® (Intuitive Surgical, Sunnyvale, CA, USA); arms position is not modified during the entire surgical procedure. Results. Twenty-five patients received a preoperative radio-chemotherapy. Surgical procedure was an abdominoperineal amputation in nine patients and an anterior resection in the remaining 37, with temporary ileostomy in 16 cases and a laparoscopic mobilization of splenic flexure in 25. Median operative time was 251 minutes, median time of first bowel movements 1.7 days and median hospital stay 6.7 days. Major complications requiring reoperation verified in 2 patients, while overall complication rate is 15.2%. Median number of harvested lymph nodes per patient was 18; median distance of the tumour from distal resection margin was 2 cm; distance of the tumour from circumferential margin was superior to 1 mm in all of the patients. At a median follow up of 11 months, all patients are alive and disease-free. Conclusion. Robotic rectal resection is a feasible technique which can provide good oncological and short-term clinical results.

Original languageItalian
Pages (from-to)527-535
Number of pages9
JournalMinerva Chirurgica
Volume66
Issue number6
Publication statusPublished - Dec 2011

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Robotics
Rectal Neoplasms
Prospective Studies
Drug Therapy
Transverse Colon
Ileostomy
Colonoscopy
Operative Time
Radio
Reoperation
Amputation
Rectum
Length of Stay
Neoplasms
Adenocarcinoma
Radiotherapy
Lymph Nodes
Magnetic Resonance Imaging
Databases
Biopsy

ASJC Scopus subject areas

  • Surgery

Cite this

Trattamento chirurgico del cancro del retto con tecnica robotica : risultati a breve termine di uno studio prospettico monocentrico. / Bianchi, P. P.; Petz, W.; Spinoglio, G.; Belotti, D.; Bertani, E.; Zampino, M. G.; Crosta, C.; Lazzari, R.; Andreoni, B.

In: Minerva Chirurgica, Vol. 66, No. 6, 12.2011, p. 527-535.

Research output: Contribution to journalArticle

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abstract = "Aim. The aim of this study was to evaluate technical feasibility, oncological safety and short-term clinical results of robotic rectal resection for cancer. Methods. From January 2008 to July 2010 , 46 patients (27 males and 19 females, median age 69 years, median BMI 24.6 kg/m 2 ) with histologically-proven adenocarcinoma of medium and distal rectum were enrolled in a prospective database. Preoperative assessment was performed with colonoscopy with biopsies, thoraco-abdominal CT scan, pelvic MRI and endorectal-ultrasound (ERUS). In the case of locally advanced non metastatic disease (T3/4 or Nl/2) , patients received preoperative radiotherapy (45 Grays in 5 weeks) and chemotherapy (oral Capecitabine). The robotic system was a four-arms Da Vinci {\circledR} (Intuitive Surgical, Sunnyvale, CA, USA); arms position is not modified during the entire surgical procedure. Results. Twenty-five patients received a preoperative radio-chemotherapy. Surgical procedure was an abdominoperineal amputation in nine patients and an anterior resection in the remaining 37, with temporary ileostomy in 16 cases and a laparoscopic mobilization of splenic flexure in 25. Median operative time was 251 minutes, median time of first bowel movements 1.7 days and median hospital stay 6.7 days. Major complications requiring reoperation verified in 2 patients, while overall complication rate is 15.2{\%}. Median number of harvested lymph nodes per patient was 18; median distance of the tumour from distal resection margin was 2 cm; distance of the tumour from circumferential margin was superior to 1 mm in all of the patients. At a median follow up of 11 months, all patients are alive and disease-free. Conclusion. Robotic rectal resection is a feasible technique which can provide good oncological and short-term clinical results.",
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T2 - risultati a breve termine di uno studio prospettico monocentrico

AU - Bianchi, P. P.

AU - Petz, W.

AU - Spinoglio, G.

AU - Belotti, D.

AU - Bertani, E.

AU - Zampino, M. G.

AU - Crosta, C.

AU - Lazzari, R.

AU - Andreoni, B.

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KW - Laparoscopy

KW - Operative

KW - Rectal neoplasms

KW - Robotics

KW - Surgical procedures

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