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- Title
Robotic versus laparoscopic rectal resection for sphincter-saving surgery: pathological and short-term outcomes in a single-center analysis of 130 consecutive patients.
- Authors
Valverde, Alain; Goasguen, Nicolas; Oberlin, Olivier; Svrcek, Magali; Fléjou, Jean-François; Sezeur, Alain; Mosnier, Henri; Houdart, Rémi; Lupinacci, Renato; Lupinacci, Renato M
- Abstract
<bold>Background: </bold>Minimally invasive sphincter-saving rectal resection represents a challenging procedure. Robotic surgery for rectal cancer has several advantages over conventional surgery in performing precise dissection and was proved to be safe and effective in previous studies. However, comparison between laparoscopic and robotic rectal resection has drawn contradictory results. The aim of the present study was to compare robotic and laparoscopic sphincter-saving rectal resections for short-term and pathological outcomes.<bold>Methods: </bold>Between January 2013 and May 2016, we performed a total of 258 robotic surgeries, including 146 colorectal resections (56%). For this study, we included the first 65 sphincter-saving robotic resections and compared them to the last 65 consecutive laparoscopic resections. The laparoscopic group was constituted by the last 65 consecutively operated patients who matched the inclusion criteria.<bold>Results: </bold>Patients' baseline characteristics were similar in both the groups. Conversion rate was greater in the laparoscopic group (17 vs. 5%, p=0.044). Reoperation rate, overall and severe morbidity, and median hospital stay were similar in both the groups. Quality of mesorectal excision specimen was considered complete or near complete in 97 and 96% in the laparoscopic and robotic groups, respectively. There was no difference in the rates of negative circumferential radial margin, distal margin, and surgical success measured by composite criteria.<bold>Conclusion: </bold>The main finding of this study was that robotic proctectomy for sphincter-saving procedures offers similar quality of TME with a statistically significant lower rate of conversion when compared to laparoscopic proctectomy.
- Subjects
ENDOSCOPIC surgery; LAPAROSCOPIC surgery; SPHINCTER surgery; SURGICAL robots; RECTAL cancer; SURGICAL excision; SURGERY; ANAL surgery; RECTAL surgery; COMPARATIVE studies; DIGESTIVE organ surgery; LENGTH of stay in hospitals; LAPAROSCOPY; RESEARCH methodology; MEDICAL cooperation; RECTUM tumors; REOPERATION; RESEARCH; SURGICAL complications; OPERATIVE surgery; EVALUATION research; TREATMENT effectiveness
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2017, Vol 31, Issue 10, p4085
- ISSN
1866-6817
- Publication type
journal article
- DOI
10.1007/s00464-017-5455-7