Robotic versus laparoscopic total mesorectal excision for rectal cancer

A comparative analysis of oncological safety and short-term outcomes

P. P. Bianchi, C. Ceriani, A. Locatelli, G. Spinoglio, M. G. Zampino, A. Sonzogni, C. Crosta, B. Andreoni

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157 Citations (Scopus)

Abstract

Background: We assessed feasibility, short-term oncologic safety, and short-term outcomes in robotic total mesorectal excision (R-TME) for rectal cancer compared with laparoscopic TME. Methods: From March 2008 to June 2009, 50 patients with proven middle/lower rectal adenocarcinoma underwent minimally invasive TME; 25 received R-TME. The groups were balanced (R-TME versus L-TME) in terms of age (median 69 versus 62 years; p = 0.8), disease stage, and body mass index (median 23 versus 26.5 kg/m 2; p = 0.06). There were 37 (74%) anterior resections and 13 (26%) abdominoperineal resections. Twenty-three (46%) patients received preoperative radiochemotherapy. The robot was a four-arm Da Vinci S (Intuitive Surgical, Sunnyvale, CA, USA). Results: Median operating time (R-TME versus L-TME) was 240 versus 237 min (p = 0.2); first bowel movement was 2 versus 3 days (p = 0.5); median hospital stay was 6.5 versus 6 days (p = 0.4). Major complications with reoperation were two in R-TME (one anastomotic leakage, one small bowel perforation) and three in L-TME (one colonic ischemia, two anastomotic leakage). Postoperative complications were 16% versus 24% (p = 0.5). A median of 18 versus 17 (p = 0.7) lymph nodes were retrieved; distal resection margins were disease free in both groups; circumferential margin was involved (

Original languageEnglish
Pages (from-to)2888-2894
Number of pages7
JournalSurgical Endoscopy and Other Interventional Techniques
Volume24
Issue number11
DOIs
Publication statusPublished - Nov 2010

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Robotics
Rectal Neoplasms
Safety
Anastomotic Leak
Chemoradiotherapy
Reoperation
Length of Stay
Adenocarcinoma
Body Mass Index
Ischemia
Lymph Nodes

Keywords

  • Laparoscopic rectal resection
  • Laparoscopic surgery
  • Rectal cancer
  • Robotic rectal resection
  • Robotic surgery
  • Total mesorectal excision

ASJC Scopus subject areas

  • Surgery

Cite this

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title = "Robotic versus laparoscopic total mesorectal excision for rectal cancer: A comparative analysis of oncological safety and short-term outcomes",
abstract = "Background: We assessed feasibility, short-term oncologic safety, and short-term outcomes in robotic total mesorectal excision (R-TME) for rectal cancer compared with laparoscopic TME. Methods: From March 2008 to June 2009, 50 patients with proven middle/lower rectal adenocarcinoma underwent minimally invasive TME; 25 received R-TME. The groups were balanced (R-TME versus L-TME) in terms of age (median 69 versus 62 years; p = 0.8), disease stage, and body mass index (median 23 versus 26.5 kg/m 2; p = 0.06). There were 37 (74{\%}) anterior resections and 13 (26{\%}) abdominoperineal resections. Twenty-three (46{\%}) patients received preoperative radiochemotherapy. The robot was a four-arm Da Vinci S (Intuitive Surgical, Sunnyvale, CA, USA). Results: Median operating time (R-TME versus L-TME) was 240 versus 237 min (p = 0.2); first bowel movement was 2 versus 3 days (p = 0.5); median hospital stay was 6.5 versus 6 days (p = 0.4). Major complications with reoperation were two in R-TME (one anastomotic leakage, one small bowel perforation) and three in L-TME (one colonic ischemia, two anastomotic leakage). Postoperative complications were 16{\%} versus 24{\%} (p = 0.5). A median of 18 versus 17 (p = 0.7) lymph nodes were retrieved; distal resection margins were disease free in both groups; circumferential margin was involved (",
keywords = "Laparoscopic rectal resection, Laparoscopic surgery, Rectal cancer, Robotic rectal resection, Robotic surgery, Total mesorectal excision",
author = "Bianchi, {P. P.} and C. Ceriani and A. Locatelli and G. Spinoglio and Zampino, {M. G.} and A. Sonzogni and C. Crosta and B. Andreoni",
year = "2010",
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doi = "10.1007/s00464-010-1134-7",
language = "English",
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T1 - Robotic versus laparoscopic total mesorectal excision for rectal cancer

T2 - A comparative analysis of oncological safety and short-term outcomes

AU - Bianchi, P. P.

AU - Ceriani, C.

AU - Locatelli, A.

AU - Spinoglio, G.

AU - Zampino, M. G.

AU - Sonzogni, A.

AU - Crosta, C.

AU - Andreoni, B.

PY - 2010/11

Y1 - 2010/11

N2 - Background: We assessed feasibility, short-term oncologic safety, and short-term outcomes in robotic total mesorectal excision (R-TME) for rectal cancer compared with laparoscopic TME. Methods: From March 2008 to June 2009, 50 patients with proven middle/lower rectal adenocarcinoma underwent minimally invasive TME; 25 received R-TME. The groups were balanced (R-TME versus L-TME) in terms of age (median 69 versus 62 years; p = 0.8), disease stage, and body mass index (median 23 versus 26.5 kg/m 2; p = 0.06). There were 37 (74%) anterior resections and 13 (26%) abdominoperineal resections. Twenty-three (46%) patients received preoperative radiochemotherapy. The robot was a four-arm Da Vinci S (Intuitive Surgical, Sunnyvale, CA, USA). Results: Median operating time (R-TME versus L-TME) was 240 versus 237 min (p = 0.2); first bowel movement was 2 versus 3 days (p = 0.5); median hospital stay was 6.5 versus 6 days (p = 0.4). Major complications with reoperation were two in R-TME (one anastomotic leakage, one small bowel perforation) and three in L-TME (one colonic ischemia, two anastomotic leakage). Postoperative complications were 16% versus 24% (p = 0.5). A median of 18 versus 17 (p = 0.7) lymph nodes were retrieved; distal resection margins were disease free in both groups; circumferential margin was involved (

AB - Background: We assessed feasibility, short-term oncologic safety, and short-term outcomes in robotic total mesorectal excision (R-TME) for rectal cancer compared with laparoscopic TME. Methods: From March 2008 to June 2009, 50 patients with proven middle/lower rectal adenocarcinoma underwent minimally invasive TME; 25 received R-TME. The groups were balanced (R-TME versus L-TME) in terms of age (median 69 versus 62 years; p = 0.8), disease stage, and body mass index (median 23 versus 26.5 kg/m 2; p = 0.06). There were 37 (74%) anterior resections and 13 (26%) abdominoperineal resections. Twenty-three (46%) patients received preoperative radiochemotherapy. The robot was a four-arm Da Vinci S (Intuitive Surgical, Sunnyvale, CA, USA). Results: Median operating time (R-TME versus L-TME) was 240 versus 237 min (p = 0.2); first bowel movement was 2 versus 3 days (p = 0.5); median hospital stay was 6.5 versus 6 days (p = 0.4). Major complications with reoperation were two in R-TME (one anastomotic leakage, one small bowel perforation) and three in L-TME (one colonic ischemia, two anastomotic leakage). Postoperative complications were 16% versus 24% (p = 0.5). A median of 18 versus 17 (p = 0.7) lymph nodes were retrieved; distal resection margins were disease free in both groups; circumferential margin was involved (

KW - Laparoscopic rectal resection

KW - Laparoscopic surgery

KW - Rectal cancer

KW - Robotic rectal resection

KW - Robotic surgery

KW - Total mesorectal excision

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JO - Surgical Endoscopy

JF - Surgical Endoscopy

SN - 0930-2794

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