Heiko Aselmann1, Jan-Niclas Kersebaum2, Alexander Bernsmeier2, Jan Henrik Beckmann2, Thorben Möller2, Jan Hendrik Egberts2, Clemens Schafmayer2, Christoph Röcken3, Thomas Becker2. 1. Klinik für Allgemein-, Viszeral-, Thorax-, Transplantations- und Kinderchirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, 24105, Kiel, Germany. heiko.aselmann@web.de. 2. Klinik für Allgemein-, Viszeral-, Thorax-, Transplantations- und Kinderchirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, 24105, Kiel, Germany. 3. Institut für Pathologie, Christian Albrechts Universität zu Kiel und Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany.
Abstract
AIM: Robotic surgery allows for a better visualization and more precise dissection especially in the narrow male pelvis and mid and lower third of the rectum. However, superiority to laparoscopic TME has yet to be proven. We therefore analyzed short-term outcomes of laparoscopic and robotic low anterior rectal resection for rectal cancer. PATIENTS AND METHODS: From 2011 to 2016, 44 robotic (RTME) and 41 laparoscopic (LTME) low anterior rectal resection with total mesorectal excision were performed at a single institution. Specimen quality was assessed and reported by an independent pathologist following international guidelines. RESULTS: The groups did not differ significantly regarding gender, age, ASA stage, BMI, and distance of the lower tumor margin from the anal verge. More patients in the RTME group underwent preoperative chemoradiation (43.2 vs. 19.5%, p = 0.019). The quality of the TME specimen was significantly better in the RTME group (complete/nearly complete/incomplete for RTME 97/0/3% and for LTME 78/17/5%, p = 0.03). The conversion rate tended to be lower in the RTME group (7 vs. 17%, p = 0.143). There was no difference in CRM positivity between the groups. CONCLUSION: Robotic surgery is safe and can improve the quality of TME for rectal cancer compared to laparoscopy. Any effect on long-term survival remains to be established.
AIM: Robotic surgery allows for a better visualization and more precise dissection especially in the narrow male pelvis and mid and lower third of the rectum. However, superiority to laparoscopic TME has yet to be proven. We therefore analyzed short-term outcomes of laparoscopic and robotic low anterior rectal resection for rectal cancer. PATIENTS AND METHODS: From 2011 to 2016, 44 robotic (RTME) and 41 laparoscopic (LTME) low anterior rectal resection with total mesorectal excision were performed at a single institution. Specimen quality was assessed and reported by an independent pathologist following international guidelines. RESULTS: The groups did not differ significantly regarding gender, age, ASA stage, BMI, and distance of the lower tumor margin from the anal verge. More patients in the RTME group underwent preoperative chemoradiation (43.2 vs. 19.5%, p = 0.019). The quality of the TME specimen was significantly better in the RTME group (complete/nearly complete/incomplete for RTME 97/0/3% and for LTME 78/17/5%, p = 0.03). The conversion rate tended to be lower in the RTME group (7 vs. 17%, p = 0.143). There was no difference in CRM positivity between the groups. CONCLUSION: Robotic surgery is safe and can improve the quality of TME for rectal cancer compared to laparoscopy. Any effect on long-term survival remains to be established.
Authors: C Pox; S Aretz; S C Bischoff; U Graeven; M Hass; P Heußner; W Hohenberger; A Holstege; J Hübner; F Kolligs; M Kreis; P Lux; J Ockenga; R Porschen; S Post; N Rahner; A Reinacher-Schick; J F Riemann; R Sauer; A Sieg; W Scheppach; W Schmitt; H J Schmoll; K Schulmann; A Tannapfel; W Schmiegel Journal: Z Gastroenterol Date: 2013-08-16 Impact factor: 2.000
Authors: P P Bianchi; C Ceriani; A Locatelli; G Spinoglio; M G Zampino; A Sonzogni; C Crosta; B Andreoni Journal: Surg Endosc Date: 2010-06-05 Impact factor: 4.584
Authors: Pierre Allemann; Céline Duvoisin; Luca Di Mare; Martin Hübner; Nicolas Demartines; Dieter Hahnloser Journal: World J Surg Date: 2016-04 Impact factor: 3.352
Authors: M Numata; S Sawazaki; K Kazama; T Aoyama; H Tamagawa; T Sato; H Mushiake; N Yukawa; M Shiozawa; M Masuda; Y Rino Journal: Tech Coloproctol Date: 2019-09-15 Impact factor: 3.781
Authors: Peter Tschann; Markus P Weigl; Daniel Lechner; Christa Mittelberger; Tarkan Jäger; Ricarda Gruber; Paolo N C Girotti; Christof Mittermair; Patrick Clemens; Christian Attenberger; Philipp Szeverinski; Thomas Brock; Jürgen Frick; Klaus Emmanuel; Ingmar Königsrainer; Jaroslav Presl Journal: Cancers (Basel) Date: 2022-06-30 Impact factor: 6.575
Authors: Marco Milone; Michele Manigrasso; Nunzio Velotti; Stefania Torino; Antonietta Vozza; Giovanni Sarnelli; Giovanni Aprea; Francesco Maione; Nicola Gennarelli; Mario Musella; Giovanni Domenico De Palma Journal: Int J Colorectal Dis Date: 2019-05-06 Impact factor: 2.571
Authors: P Tejedor; F Sagias; K Flashman; Yeh Han Lee; S Naqvi; N Kandala; Jim Khan Journal: Int J Colorectal Dis Date: 2019-11-11 Impact factor: 2.571