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Open Access 01-12-2022 | Rectal Cancer | Research

Robotic surgery contributes to the preservation of bowel and urinary function after total mesorectal excision: comparisons with transanal and conventional laparoscopic surgery

Authors: Takuya Miura, Yoshiyuki Sakamoto, Hajime Morohashi, Akiko Suto, Shunsuke Kubota, Aika Ichisawa, Daisuke Kuwata, Takahiro Yamada, Hiroaki Tamba, Shuntaro Matsumoto, Kenichi Hakamada

Published in: BMC Surgery | Issue 1/2022

Abstract

Background

Determine whether robotic surgery is more effective than transanal and conventional laparoscopic surgery in preserving bowel and urinary function after total mesorectal excision (TME).

Methods

Of 79 lower rectal cancer patients who underwent function-preserving TME between 2016 and 2020, 64 patients consented to a prospective questionnaire-based functional observation study (52 responded). At 6 months post-resection or ileostomy closure, Wexner, low anterior resection syndrome (LARS), modified fecal incontinence quality of life, and international prostate symptom scores were used to evaluate bowel and urinary function, comparing robotic surgery (RTME) with transanal (taTME) or conventional laparoscopic surgery (LTME).

Results

RTME was performed in 35 patients (54.7%), taTME in 15 (23.4%), and LTME in 14 (21.9%). While preoperative bowel/urinary functions were similar in all three procedures, and the distance from the anal verge to tumor was almost the same, more hand-sewn anastomoses were performed and the anastomotic height from the anal verge was shorter in taTME than RTME. At 2 years post-resection, 8 patients (12.5%) had a permanent stoma; RTME showed a significantly lower rate of permanent stoma than taTME (2.9% vs. 40%, p < 0.01). Despite no significant difference, all bowel function assessments were better in RTME than in taTME or LTME. Major LARS was observed in all taTME and LTME cases, but only 78.8% of RTME. No clear difference arose between RTME and taTME in urinary function; urinary dysfunction was more severe in LTME than RTME (36.4% vs. 6.1%, p = 0.02).

Conclusions

In function-preserving TME for lower rectal cancer, robotic surgery was suggested to be more effective than transanal and conventional laparoscopic surgery in terms of bowel and urinary functions.

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Title: Robotic surgery contributes to the preservation of bowel and urinary function after total mesorectal excision: comparisons with transanal and conventional laparoscopic surgery
Authors: Takuya Miura
Yoshiyuki Sakamoto
Hajime Morohashi
Akiko Suto
Shunsuke Kubota
Aika Ichisawa
Daisuke Kuwata
Takahiro Yamada
Hiroaki Tamba
Shuntaro Matsumoto
Kenichi Hakamada
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Rectal Cancer
Rectal Cancer
Enterostomy
Fecal Incontinence
Enterostomy
Published in: BMC Surgery / Issue 1/2022
Electronic ISSN: 1471-2482
DOI: https://doi.org/10.1186/s12893-022-01596-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Robotic surgery contributes to the preservation of bowel and urinary function after total mesorectal excision: comparisons with transanal and conventional laparoscopic surgery

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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