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Surgical Endoscopy
Published in: Surgical Endoscopy 10/2017

01-10-2017

Robotic versus laparoscopic rectal resection for sphincter-saving surgery: pathological and short-term outcomes in a single-center analysis of 130 consecutive patients

Authors: Alain Valverde, Nicolas Goasguen, Olivier Oberlin, Magali Svrcek, Jean-François Fléjou, Alain Sezeur, Henri Mosnier, Rémi Houdart, Renato M. Lupinacci

Published in: Surgical Endoscopy | Issue 10/2017

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Abstract

Background

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.

Methods

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.

Results

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.

Conclusion

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.
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Metadata
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
Alain Valverde
Nicolas Goasguen
Olivier Oberlin
Magali Svrcek
Jean-François Fléjou
Alain Sezeur
Henri Mosnier
Rémi Houdart
Renato M. Lupinacci
Publication date
01-10-2017
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 10/2017
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-017-5455-7

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