Jin C Kim1, Seok-B Lim, Yong S Yoon, In J Park, Chan W Kim, Chang N Kim. 1. Colorectal Division, Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, 88, Olympic-ro-43-gil, Songpa-gu, Seoul, 138-736, Korea, jckim@amc.seoul.kr.
Abstract
BACKGROUND: Most previous studies of intersphincteric resection (ISR) adopted a two-stage procedure involving abdominal and transanal approaches. We performed completely abdominal ISR via open and a robot-assisted (RA) approaches as treatments for lower rectal cancer (LRC). The RA approach might enable deep dissection and facilitate ISR in patients with restrictive pelvic anatomy. METHODS: A consecutive cohort of 222 LRC patients who underwent completely abdominal ISR (RA ISR, n = 108; open ISR, n = 114) was enrolled prospectively, and their short-term outcomes were evaluated. RESULTS: In a multivariate analysis, ISR was performed more frequently in the RA than in the open group (82.6 vs. 67.9 %, p = 0.008). The number of harvested lymph nodes was >12 in both groups. A positive distal resection margin was not observed in either group, and a positive circumferential resection margin was found in one patient in the RA group. Overall morbidity did not differ between the groups. Moderate to severe sexual dysfunction occurred 2.7-fold more frequently in the open group (p = 0.023) among male patients ≤65 years. Mean Wexner's fecal incontinence scores at postoperative months 6 and 12 were greater in the open group than in the RA group (p < 0.05). CONCLUSIONS: Completely abdominal ISR may be feasible in the treatment of LRC, based on a short-term study. Furthermore, RA ISR had equivalent oncological outcomes and slightly improved functional recovery relative to open ISR.
BACKGROUND: Most previous studies of intersphincteric resection (ISR) adopted a two-stage procedure involving abdominal and transanal approaches. We performed completely abdominal ISR via open and a robot-assisted (RA) approaches as treatments for lower rectal cancer (LRC). The RA approach might enable deep dissection and facilitate ISR in patients with restrictive pelvic anatomy. METHODS: A consecutive cohort of 222 LRC patients who underwent completely abdominal ISR (RA ISR, n = 108; open ISR, n = 114) was enrolled prospectively, and their short-term outcomes were evaluated. RESULTS: In a multivariate analysis, ISR was performed more frequently in the RA than in the open group (82.6 vs. 67.9 %, p = 0.008). The number of harvested lymph nodes was >12 in both groups. A positive distal resection margin was not observed in either group, and a positive circumferential resection margin was found in one patient in the RA group. Overall morbidity did not differ between the groups. Moderate to severe sexual dysfunction occurred 2.7-fold more frequently in the open group (p = 0.023) among male patients ≤65 years. Mean Wexner's fecal incontinence scores at postoperative months 6 and 12 were greater in the open group than in the RA group (p < 0.05). CONCLUSIONS: Completely abdominal ISR may be feasible in the treatment of LRC, based on a short-term study. Furthermore, RA ISR had equivalent oncological outcomes and slightly improved functional recovery relative to open ISR.
Authors: S Trastulli; R Cirocchi; C Listorti; D Cavaliere; N Avenia; N Gullà; G Giustozzi; F Sciannameo; G Noya; C Boselli Journal: Colorectal Dis Date: 2012-06 Impact factor: 3.788
Authors: F Rondelli; P Reboldi; A Rulli; F Barberini; A Guerrisi; L Izzo; A Bolognese; P Covarelli; C Boselli; C Becattini; G Noya Journal: Int J Colorectal Dis Date: 2009-02-12 Impact factor: 2.571
Authors: Jin Cheon Kim; Chang Sik Yu; Seok-Byung Lim; In Ja Park; Chan Wook Kim; Yong Sik Yoon Journal: Int J Colorectal Dis Date: 2016-04-15 Impact factor: 2.571
Authors: Jin Cheon Kim; Jong Lyul Lee; Abdulrahman Muaod Alotaibi; Yong Sik Yoon; Chan Wook Kim; In Ja Park Journal: Int J Colorectal Dis Date: 2017-03-29 Impact factor: 2.571