C Galata1, G Vassilev1, F Haas1, P Kienle2, S Büttner3, C Reißfelder1, Julia Hardt4,5. 1. Department of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany. 2. Department of Surgery, Theresienkrankenhaus Mannheim, Mannheim, Germany. 3. Department of Medical Statistics and Biomathematics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany. 4. Department of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany. julia.hardt@umm.des. 5. Department of Surgery, University Hospital Mannheim, Faculty of the University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany. julia.hardt@umm.des.
Abstract
PURPOSE: Despite the increasing use of telemanipulators in colorectal surgery, an additional benefit in terms of improved perioperative results is not proven. The aim of the study was to compare clinical, oncological, and functional results of Da Vinci (Xi)-assisted versus conventional laparoscopic (low) anterior resection for rectal cancer. METHODS: Monocenter, prospective, controlled cohort study with a 12-month follow-up of bladder and sexual function using the validated questionnaires International Prostate Symptom Score, International Index of Erectile Function, and Female Sexual Function Index. RESULTS: Fifty-one patients were included (18, Da Vinci (Xi) assisted; 33, conventional laparoscopy). Conversion to an open approach was more common in the Da Vinci cohort (p = 0.012). In addition, surgery and resumption of a normal diet took longer in the robotic group (p = 0.005; p = 0.042). Surgical morbidity and oncological quality did not differ. There was no difference in most functional domains, except for worsened ability to orgasm (p = 0.047) and sexual satisfaction (p = 0.034) in women after conventional laparoscopy. Moreover, we found a higher rate of improved bladder function in the conventional laparoscopy group (p = 0.023) and less painful sexual intercourse among women in the robot-assisted group (p = 0.049). CONCLUSION: In contrast to the ROLARR trial, a higher conversion rate was found in the robotic cohort, which may in part be explained by a learning curve effect. Nevertheless, the Da Vinci-assisted approach showed favorable results regarding sexual function.
PURPOSE: Despite the increasing use of telemanipulators in colorectal surgery, an additional benefit in terms of improved perioperative results is not proven. The aim of the study was to compare clinical, oncological, and functional results of Da Vinci (Xi)-assisted versus conventional laparoscopic (low) anterior resection for rectal cancer. METHODS: Monocenter, prospective, controlled cohort study with a 12-month follow-up of bladder and sexual function using the validated questionnaires International Prostate Symptom Score, International Index of Erectile Function, and Female Sexual Function Index. RESULTS: Fifty-one patients were included (18, Da Vinci (Xi) assisted; 33, conventional laparoscopy). Conversion to an open approach was more common in the Da Vinci cohort (p = 0.012). In addition, surgery and resumption of a normal diet took longer in the robotic group (p = 0.005; p = 0.042). Surgical morbidity and oncological quality did not differ. There was no difference in most functional domains, except for worsened ability to orgasm (p = 0.047) and sexual satisfaction (p = 0.034) in women after conventional laparoscopy. Moreover, we found a higher rate of improved bladder function in the conventional laparoscopy group (p = 0.023) and less painful sexual intercourse among women in the robot-assisted group (p = 0.049). CONCLUSION: In contrast to the ROLARR trial, a higher conversion rate was found in the robotic cohort, which may in part be explained by a learning curve effect. Nevertheless, the Da Vinci-assisted approach showed favorable results regarding sexual function.
Entities:
Keywords:
Laparoscopic; Rectal cancer; Robotic; Surgery
Authors: Rosa M Jiménez-Rodríguez; Mercedes Rubio-Dorado-Manzanares; José Manuel Díaz-Pavón; M Luisa Reyes-Díaz; Jorge Manuel Vazquez-Monchul; Ana M Garcia-Cabrera; Javier Padillo; Fernando De la Portilla Journal: Int J Colorectal Dis Date: 2016-10-06 Impact factor: 2.571
Authors: Chetna Ravindra; Emmanuelar O Igweonu-Nwakile; Safina Ali; Salomi Paul; Shreyas Yakkali; Sneha Teresa Selvin; Sonu Thomas; Viktoriya Bikeyeva; Ahmed Abdullah; Aleksandra Radivojevic; Anas A Abu Jad; Anvesh Ravanavena; Prachi Balani Journal: Cureus Date: 2022-07-19