Tomohiro Yamaguchi1,2, Yusuke Kinugasa3,4, Akio Shiomi1, Hiroyasu Kagawa1, Yushi Yamakawa1, Akinobu Furuatni1, Shoichi Manabe1, Yusuke Yamaoka1, Hitoshi Hino1. 1. Division of Colon and Rectal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan. 2. Department of Gastroenterological Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto, Tokyo, 135-8550, Japan. 3. Division of Colon and Rectal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan. kinugasa.srg1@tmd.ac.jp. 4. Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan. kinugasa.srg1@tmd.ac.jp.
Abstract
PURPOSE: Scientific evidence supporting robotic-assisted laparoscopic surgery (RALS) for rectal cancer remains inconclusive because most previous reports were retrospective case series or case-control studies, with few reports focusing on long-term oncological outcomes with a large volume of patients. The aim of this study was to clarify the short- and long-term outcomes of a large number of consecutive patients with rectal cancer who underwent RALS in a single high-volume center. METHODS: The records of 551 consecutive patients who underwent RALS for rectal adenocarcinoma between December 2011 and March 2017 were examined to reveal the short-term outcomes. The oncological outcomes of the 204 patients who underwent surgery between December 2011 and March 2014 were evaluated. RESULTS: Most patients had tumors located in the lower or mid-rectum (86.0%). Only 7.6% of patients underwent neoadjuvant chemoradiotherapy. Lateral lymph node dissection was performed for 191 patients (34.7%). The median operative time was 257 min, median blood loss was 10 mL, and no transfusions were needed. No conversion to open surgery was necessary. Eighteen patients (3.3%) had Clavien-Dindo grade III postoperative complications. Six patients (1.1%) had positive resection margins. The mean follow-up duration of the 204 patients was 43.6 ± 9.8 (months). The 5-year cancer-specific survival rate for stage I/II/III/IV was 100%/100%/100%/not reached, respectively. The 5-year relapse-free survival rate for stage I/II/III/IV was 93.6%/75.0%/77.6%/ not reached, respectively. The rate of local recurrence was 0.5%. CONCLUSIONS: Our results suggest that RALS is technically feasible for rectal cancer and has good short- and long-term outcomes.
PURPOSE: Scientific evidence supporting robotic-assisted laparoscopic surgery (RALS) for rectal cancer remains inconclusive because most previous reports were retrospective case series or case-control studies, with few reports focusing on long-term oncological outcomes with a large volume of patients. The aim of this study was to clarify the short- and long-term outcomes of a large number of consecutive patients with rectal cancer who underwent RALS in a single high-volume center. METHODS: The records of 551 consecutive patients who underwent RALS for rectal adenocarcinoma between December 2011 and March 2017 were examined to reveal the short-term outcomes. The oncological outcomes of the 204 patients who underwent surgery between December 2011 and March 2014 were evaluated. RESULTS: Most patients had tumors located in the lower or mid-rectum (86.0%). Only 7.6% of patients underwent neoadjuvant chemoradiotherapy. Lateral lymph node dissection was performed for 191 patients (34.7%). The median operative time was 257 min, median blood loss was 10 mL, and no transfusions were needed. No conversion to open surgery was necessary. Eighteen patients (3.3%) had Clavien-Dindo grade III postoperative complications. Six patients (1.1%) had positive resection margins. The mean follow-up duration of the 204 patients was 43.6 ± 9.8 (months). The 5-year cancer-specific survival rate for stage I/II/III/IV was 100%/100%/100%/not reached, respectively. The 5-year relapse-free survival rate for stage I/II/III/IV was 93.6%/75.0%/77.6%/ not reached, respectively. The rate of local recurrence was 0.5%. CONCLUSIONS: Our results suggest that RALS is technically feasible for rectal cancer and has good short- and long-term outcomes.
Authors: Rosa M Jiménez Rodríguez; José M Díaz Pavón; Fernando de La Portilla de Juan; Emilio Prendes Sillero; Jean Marie Hisnard Cadet Dussort; Javier Padillo Journal: Cir Esp Date: 2011-04-29 Impact factor: 1.653
Authors: Pierre J Guillou; Philip Quirke; Helen Thorpe; Joanne Walker; David G Jayne; Adrian M H Smith; Richard M Heath; Julia M Brown Journal: Lancet Date: 2005 May 14-20 Impact factor: 79.321
Authors: Zhifei Sun; Jina Kim; Mohamed A Adam; Daniel P Nussbaum; Paul J Speicher; Christopher R Mantyh; John Migaly Journal: Ann Surg Date: 2016-06 Impact factor: 12.969
Authors: David Jayne; Alessio Pigazzi; Helen Marshall; Julie Croft; Neil Corrigan; Joanne Copeland; Phil Quirke; Nick West; Tero Rautio; Niels Thomassen; Henry Tilney; Mark Gudgeon; Paolo Pietro Bianchi; Richard Edlin; Claire Hulme; Julia Brown Journal: JAMA Date: 2017-10-24 Impact factor: 56.272
Authors: T Matsuyama; H Endo; H Yamamoto; I Takemasa; K Uehara; T Hanai; H Miyata; T Kimura; H Hasegawa; Y Kakeji; M Inomata; Y Kitagawa; Y Kinugasa Journal: BJS Open Date: 2021-09-06