Total mesorectal excision for mid and low rectal cancer: Laparoscopic vs robotic surgery

Francesco Feroci, Andrea Vannucchi, Paolo Pietro Bianchi, Stefano Cantafio, Alessia Garzi, Giampaolo Formisano, Marco Scatizzi

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

AIM: To compare the short- and long-term outcomes of laparoscopic and robotic surgery for middle and low rectal cancer. METHODS: This is a retrospective study on a prospectively collected database containing 111 patients who underwent minimally invasive rectal resection with total mesorectal excision (TME) with curative intent between January 2008 and December 2014 (robot, n = 53; laparoscopy, n = 58). The patients all had a diagnosis of middle and low rectal adenocarcinoma with stage I-III disease. The median follow-up period was 37.4 mo. Perioperative results, morbidity a pathological data were evaluated and compared. The 3-year overall survival and disease-free survival rates were calculated and compared. RESULTS: Patients were comparable in terms of preoperative and demographic parameters. The median surgery time was 192 min for laparoscopic TME (L-TME) and 342 min for robotic TME (R-TME) (P <0.001). There were no differences found in the rates of conversion to open surgery and morbidity. The patients who underwent laparoscopic surgery stayed in the hospital two days longer than the robotic group patients (8 d for L-TME and 6 d for R-TME, P <0.001). The pathologic evaluation showed a higher number of harvested lymph nodes in the robotic group (18 for R-TME, 11 for L-TME, P <0.001) and a shorter distal resection margin for laparoscopic patients (1.5 cm for L-TME, 2.5 cm for R-TME, P <0.001). The three-year overall survival and disease-free survival rates were similar between groups. CONCLUSION: Both L-TME and R-TME achieved acceptable clinical and oncologic outcomes. The robotic technique showed some advantages in rectal surgery that should be validated by further studies.

Original languageEnglish
Pages (from-to)3602-3610
Number of pages9
JournalWorld Journal of Gastroenterology
Volume22
Issue number13
DOIs
Publication statusPublished - Apr 7 2016

Fingerprint

Robotics
Rectal Neoplasms
Laparoscopy
Disease-Free Survival
Survival Rate
Conversion to Open Surgery
Morbidity
Survival
Adenocarcinoma
Retrospective Studies
Lymph Nodes
Demography
Databases

Keywords

  • Laparoscopic surgery
  • Minimally invasive surgery
  • Rectal cancer
  • Robotic surgery
  • Total mesorectal excision

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Feroci, F., Vannucchi, A., Bianchi, P. P., Cantafio, S., Garzi, A., Formisano, G., & Scatizzi, M. (2016). Total mesorectal excision for mid and low rectal cancer: Laparoscopic vs robotic surgery. World Journal of Gastroenterology, 22(13), 3602-3610. https://doi.org/10.3748/wjg.v22.i13.3602

Total mesorectal excision for mid and low rectal cancer : Laparoscopic vs robotic surgery. / Feroci, Francesco; Vannucchi, Andrea; Bianchi, Paolo Pietro; Cantafio, Stefano; Garzi, Alessia; Formisano, Giampaolo; Scatizzi, Marco.

In: World Journal of Gastroenterology, Vol. 22, No. 13, 07.04.2016, p. 3602-3610.

Research output: Contribution to journalArticle

Feroci, F, Vannucchi, A, Bianchi, PP, Cantafio, S, Garzi, A, Formisano, G & Scatizzi, M 2016, 'Total mesorectal excision for mid and low rectal cancer: Laparoscopic vs robotic surgery', World Journal of Gastroenterology, vol. 22, no. 13, pp. 3602-3610. https://doi.org/10.3748/wjg.v22.i13.3602
Feroci F, Vannucchi A, Bianchi PP, Cantafio S, Garzi A, Formisano G et al. Total mesorectal excision for mid and low rectal cancer: Laparoscopic vs robotic surgery. World Journal of Gastroenterology. 2016 Apr 7;22(13):3602-3610. https://doi.org/10.3748/wjg.v22.i13.3602
Feroci, Francesco ; Vannucchi, Andrea ; Bianchi, Paolo Pietro ; Cantafio, Stefano ; Garzi, Alessia ; Formisano, Giampaolo ; Scatizzi, Marco. / Total mesorectal excision for mid and low rectal cancer : Laparoscopic vs robotic surgery. In: World Journal of Gastroenterology. 2016 ; Vol. 22, No. 13. pp. 3602-3610.
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