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- Title
Selective lateral pelvic lymph node dissection: a comparative study of the robotic versus laparoscopic approach.
- Authors
Kim, Hye Jin; Choi, Gyu-Seog; Park, Jun Seok; Park, Soo Yeun; Lee, Hee Jae; Woo, In Taek; Park, In Kyu
- Abstract
<bold>Background: </bold>Lateral pelvic lymph node dissection (LPND) is a challenging procedure due to its technical difficulty and higher incidence of surgical morbidity. We compared short-term outcomes between laparoscopic and robotic LPND in patients with rectal cancer.<bold>Methods: </bold>Between May 2006 and December 2014, prospectively collected data from consecutive patients undergoing robotic or laparoscopic total mesorectal excision (TME) with LPND were retrospectively compared. Patients' demographics, perioperative outcomes, functional results, and initial oncologic outcomes were analyzed.<bold>Results: </bold>Fifty and 35 patients underwent robotic or laparoscopic TME with LPND, respectively. Bilateral LPND was performed in 10 patients (20%) in the robotic group and 6 (17.1%) in the laparoscopic group. For unilateral pelvic dissection, the mean operative time was not significantly different between groups (robotic vs. laparoscopic group, 41.0 ± 15.8 min vs. 35.3 ± 13.4 min; P = 0.146), but the EBL was significantly lower in the robotic group (34.6 ± 21.9 mL vs. 50.6 ± 23.8 mL; P = 0.002). Two patients (4.0%) in the robotic group and 7 (20.0%) in the laparoscopic group underwent Foley catheter reinsertion for urinary retention postoperatively (P = 0.029). The mean number of harvested lateral pelvic lymph nodes (LPNs) was 6.6 (range 0-25) in the robotic group and 6.4 (range 1-14) in the laparoscopic group. Pathologic LPN metastatic rate was not different between groups (robotic vs. laparoscopic group, 28.0 vs. 41.2%; P = 0.243). During the median follow-up of 26.3 months, overall recurrence rate was not different between groups (robotic vs. laparoscopic group, 30.0 vs. 31.2%; P = 0.850). Three patients (6.0%) in the robotic group and 4 (11.4%) in the laparoscopic group developed local recurrence (P = 0.653).<bold>Conclusions: </bold>Robotic TME with LPND is safe and feasible with favorable short-term surgical outcomes.
- Subjects
LYMPHADENECTOMY; SURGICAL robots; LAPAROSCOPIC surgery; RECTAL cancer treatment; METASTASIS; CANCER relapse; COMPARATIVE studies; SURGICAL excision; LAPAROSCOPY; LYMPH node surgery; RESEARCH methodology; MEDICAL cooperation; RECTUM tumors; RESEARCH; RESEARCH funding; SURGICAL complications; EVALUATION research; RETROSPECTIVE studies
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2018, Vol 32, Issue 5, p2466
- ISSN
1866-6817
- Publication type
journal article
- DOI
10.1007/s00464-017-5948-4