James Chi-Yong Ngu1, Li-Jen Kuo2,3, Ching-Huei Kung4, Chi-Long Chen5, Chia-Chun Kuo6, Sheng-Wei Chang7, Chia-Che Chen2. 1. Department of Surgery, Changi General Hospital, Singapore, Singapore. 2. Division of Colorectal Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei, Taiwan. 3. Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. 4. Department of Diagnostic Radiology, Taipei Medical University Hospital, Taipei, Taiwan. 5. Department of Pathology, Taipei Medical University Hospital, Taipei, Taiwan. 6. Department of Radiation Oncology, Taipei Medical University Hospital, Taipei, Taiwan. 7. Division of Acute Care Surgery and Traumatology, Department of Surgery, Taipei Medical University Hospital, Taipei, Taiwan.
Abstract
BACKGROUND: Full-thickness local excision (FTLE) for rectal cancer showing clinical complete remission (cCR) after neoadjuvant chemoradiation therapy (NCRT) is associated with good oncological results. The purpose of this study was to report the results of robotic transanal minimally invasive surgery for such patients. METHODS: Patients were treated with a 5-fluorouracil-based NCRT regimen. The determination of cCR was based on digital rectal examination, colonoscopy, and magnetic resonance imaging. RESULTS: Six patients underwent transanal FTLE using the da Vinci Xi surgical system. The median operative time was 106.5 minutes, and the estimated blood loss was minimal. The mean length of hospital stay was 4.2 days. After 18.2 months of follow-up, none of the patients developed local recurrences or distant disease. CONCLUSIONS: With the use of robotic technology, FTLE can be performed with relative ease and can be considered as a viable alternative to radical resection or a "Watch and Wait" strategy.
BACKGROUND: Full-thickness local excision (FTLE) for rectal cancer showing clinical complete remission (cCR) after neoadjuvant chemoradiation therapy (NCRT) is associated with good oncological results. The purpose of this study was to report the results of robotic transanal minimally invasive surgery for such patients. METHODS:Patients were treated with a 5-fluorouracil-based NCRT regimen. The determination of cCR was based on digital rectal examination, colonoscopy, and magnetic resonance imaging. RESULTS: Six patients underwent transanal FTLE using the da Vinci Xi surgical system. The median operative time was 106.5 minutes, and the estimated blood loss was minimal. The mean length of hospital stay was 4.2 days. After 18.2 months of follow-up, none of the patients developed local recurrences or distant disease. CONCLUSIONS: With the use of robotic technology, FTLE can be performed with relative ease and can be considered as a viable alternative to radical resection or a "Watch and Wait" strategy.