Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2010

01-06-2010 | Colorectal Cancer

Multicentric Study on Robotic Tumor-Specific Mesorectal Excision for the Treatment of Rectal Cancer

Authors: Alessio Pigazzi, Fabrizio Luca, Alberto Patriti, Manuela Valvo, Graziano Ceccarelli, Luciano Casciola, Roberto Biffi, Julio Garcia-Aguilar, Jeong-Heum Baek

Published in: Annals of Surgical Oncology | Issue 6/2010

Login to get access

Abstract

Background

Recently, traditional laparoscopic anterior resection has been used for rectal cancer, offering good functional results compared with open resection and resulting in better early postoperative outcomes. Few studies investigating the role of robot-assisted tumor-specific rectal surgery (RTSRS) have been carried out to show its feasibility. The aim of the study was to verify on a multicentric basis the perioperative and oncologic outcome of RTSRS.

Methods

One hundred forty-three consecutive patients undergoing RTSR in three centers were reviewed. Pathologic data, and postoperative and oncologic outcome measures were prospectively collected and analyzed by an independent researcher.

Results

A total of 112 restorative surgeries and 31 abdominoperineal resections were carried out. Conversion rate was 4.9%, mean blood loss was 283 ml, and mean operative time was 297 min. The number of harvested nodes (14.1 ± 6.5) and margin status compared favorably with those of open series (mean distal margin 2.9 ± 1.8 cm; negative radial margin in 142 cases). The 3-year overall survival rate was 97%, and no isolated local recurrences were found at mean follow-up of 17.4 months.

Conclusion

RTSRS is a safe and feasible procedure that may facilitate mesorectal excision. Randomized clinical trials and longer follow-up are needed to evaluate a possible influence of RTSRS on patient survival.
Literature
1.
Aziz O, Constantinides V, Tekkis PP, et al. Laparoscopic versus open surgery for rectal cancer: a meta-analysis. Ann Surg Oncol. 2006;13(3):413–24.CrossRefPubMed
2.
Kuhry E, Schwenk W, Gaupset R, et al. Long-term outcome of laparoscopic surgery for colorectal cancer: a cochrane systematic review of randomised controlled trials. Cancer Treat Rev. 2008;34(6):498–504.CrossRefPubMed
3.
4.
Hellan M, Anderson C, Ellenhorn JD, et al. Short-term outcomes after robotic-assisted total mesorectal excision for rectal cancer. Ann Surg Oncol. 2007;14(11):3168–73.CrossRefPubMed
5.
Spinoglio G, Summa M, Priora F, et al. Robotic colorectal surgery: first 50 cases experience. Dis Colon Rectum. 2008;51(11):1627–32.CrossRefPubMed
6.
Luca F, Cenciarelli S, Valvo M, et al. Full robotic left colon and rectal cancer resection: technique and early outcome. Ann Surg Oncol. 2009;16(5):1274–8.CrossRefPubMed
7.
Baik SH, Ko YT, Kang CM, et al. Robotic tumor-specific mesorectal excision of rectal cancer: short-term outcome of a pilot randomized trial. Surg Endosc. 2008;22(7):1601–8.CrossRefPubMed
8.
Heald RJ, Husband EM, Ryall RD. The mesorectum in rectal cancer surgery–the clue to pelvic recurrence? Br J Surg. 1982;69(10):613–6.CrossRefPubMed
9.
Leong AF. Selective total mesorectal excision for rectal cancer. Dis Colon Rectum. 2000;43(9):1237–40.CrossRefPubMed
10.
Pigazzi A, Ellenhorn JD, Ballantyne GH, Paz IB. Robotic-assisted laparoscopic low anterior resection with total mesorectal excision for rectal cancer. Surg Endosc. 2006;20(10):1521–5.CrossRefPubMed
11.
Hellan M, Stein H, Pigazzi A. Totally robotic low anterior resection with total mesorectal excision and splenic flexure mobilization. Surg Endosc. 2009;23(2):447–51.CrossRefPubMed
12.
D’Annibale A, Morpurgo E, Fiscon V, et al. Robotic and laparoscopic surgery for treatment of colorectal diseases. Dis Colon Rectum. 2004;47(12):2162–8.CrossRefPubMed
13.
Patriti A, Ceccarelli G, Bartoli A, et al. Short- and medium-term outcome of robot-assisted and traditional laparoscopic rectal resection. JSLS. 2009;13(2):176–83.PubMed
14.
Patriti A, Ceccarelli G, Bellochi R, et al. Robot-assisted laparoscopic total and partial gastric resection with D2 lymph node dissection for adenocarcinoma. Surg Endosc. 2008;22(12):2753–60.CrossRefPubMed
15.
Gutt CN, Oniu T, Mehrabi A, et al. Robot-assisted abdominal surgery. Br J Surg. 2004;91(11):1390–7.CrossRefPubMed
16.
Rodriguez-Ramirez SE, Uribe A, Ruiz-Garcia EB, et al. Risk factors for anastomotic leakage after preoperative chemoradiation therapy and low anterior resection with total mesorectal excision for locally advanced rectal cancer. Rev Invest Clin. 2006;58(3):204–10.PubMed
17.
Morino M, Parini U, Giraudo G, et al. Laparoscopic total mesorectal excision: a consecutive series of 100 patients. Ann Surg. 2003;237(3):335–42.CrossRefPubMed
18.
Leroy J, Jamali F, Forbes L, et al. Laparoscopic total mesorectal excision (TME) for rectal cancer surgery: long-term outcomes. Surg Endosc. 2004;18(2):281–9.CrossRefPubMed
19.
Laurent C, Leblanc F, Wutrich P, et al. Laparoscopic versus open surgery for rectal cancer: long-term oncologic results. Ann Surg. 2009;250(1):54–61.CrossRefPubMed
20.
Ceelen WP, Van Nieuwenhove Y, Fierens K. Preoperative chemoradiation versus radiation alone for stage II and III resectable rectal cancer. Cochrane Database Syst Rev. 2009(1):CD006041.
21.
Bosset JF, Collette L, Calais G, et al. Chemotherapy with preoperative radiotherapy in rectal cancer. N Engl J Med. 2006;355(11):1114–23.CrossRefPubMed
22.
Ziogas D, Roukos D. Robotic surgery for rectal cancer: may it improve also survival? Surg Endosc. 2008;22(5):1405–6.CrossRefPubMed
23.
Gouvas N, Tsiaoussis J, Pechlivanides G, et al. Quality of surgery for rectal carcinoma: comparison between open and laparoscopic approaches. Am J Surg. 2009;198(5):702–8.CrossRefPubMed
24.
Bretagnol F, Lelong B, Laurent C, et al. The oncological safety of laparoscopic total mesorectal excision with sphincter preservation for rectal carcinoma. Surg Endosc. 2005;19(7):892–6.CrossRefPubMed
25.
Veldkamp R, Kuhry E, Hop WC, et al. Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol. 2005;6(7):477–84.CrossRefPubMed
26.
Strohlein MA, Grutzner KU, Jauch KW, Heiss MM. Comparison of laparoscopic vs. open access surgery in patients with rectal cancer: a prospective analysis. Dis Colon Rectum. 2008;51(4):385–91.
27.
Kennedy GD, Heise C, Rajamanickam V, et al. Laparoscopy decreases postoperative complication rates after abdominal colectomy: results from the national surgical quality improvement program. Ann Surg. 2009;249(4):596–601.CrossRefPubMed
28.
Pugliese R, Di Lernia S, Sansonna F, et al. Results of laparoscopic anterior resection for rectal adenocarcinoma: retrospective analysis of 157 cases. Am J Surg. 2008;195(2):233–8.CrossRefPubMed
29.
Capussotti L, Massucco P, Muratore A, et al. Laparoscopy as a prognostic factor in curative resection for node positive colorectal cancer: results for a single-institution nonrandomized prospective trial. Surg Endosc. 2004;18(7):1130–5.CrossRefPubMed
30.
Lacy AM, Delgado S, Castells A, et al. The long-term results of a randomized clinical trial of laparoscopy-assisted versus open surgery for colon cancer. Ann Surg. 2008;248(1):1–7.CrossRefPubMed
31.
Jayaraman S, Quan D, Al-Ghamdi I, et al. Does robotic assistance improve efficiency in performing complex minimally invasive surgical procedures? Surg Endosc. 2009 July 25. [Epub ahead of print].
Metadata
Title
Multicentric Study on Robotic Tumor-Specific Mesorectal Excision for the Treatment of Rectal Cancer
Authors
Alessio Pigazzi
Fabrizio Luca
Alberto Patriti
Manuela Valvo
Graziano Ceccarelli
Luciano Casciola
Roberto Biffi
Julio Garcia-Aguilar
Jeong-Heum Baek
Publication date
01-06-2010
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 6/2010
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-010-0909-3

Other articles of this Issue 6/2010

Annals of Surgical Oncology 6/2010 Go to the issue

Urologic Oncology

Clinical Significance of Tumor Necrosis Factor Receptor Superfamily Member 11b Polymorphism in Prostate Cancer

Healthcare Policy and Outcomes

Characteristics and Outcomes of Methicillin-Resistant Staphylococcus aureus Surgical-Site Infections in Patients with Cancer: a Case–Control Study

Pancreatic Tumors

Parenchyma-Preserving Resections for Small Nonfunctioning Pancreatic Endocrine Tumors

Gynecologic Oncology

Influence of Residual Tumor on Outcome in Ovarian Cancer Patients With FIGO Stage IV Disease

Endocrine Tumors

New Operative Surgical Concept of Two Fascial Layers Enveloping the Recurrent Laryngeal Nerve

Colorectal Cancer

Body Mass Index does not Affect Postoperative Morbidity and Oncologic Outcomes of Total Mesorectal Excision for Rectal Adenocarcinoma