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International Journal of Colorectal Disease

Published in:

01-06-2016 | Original Article

Robotic surgery with high dissection and low ligation technique for consecutive patients with rectal cancer following preoperative concurrent chemoradiotherapy

Authors: Ching-Wen Huang, Yung-Sung Yeh, Wei-Chih Su, Hsiang-Lin Tsai, Tak-Kee Choy, Ming-Yii Huang, Chun-Ming Huang, I-Chen Wu, Huang-Ming Hu, Wen-Hung Hsu, Yu-Chung Su, Jaw-Yuan Wang

Published in: International Journal of Colorectal Disease | Issue 6/2016

Abstract

Purpose

We present the preliminary experiences with and short-term outcomes of 50 consecutive patients with rectal cancer who underwent preoperative concurrent chemoradiotherapy (CCRT) followed by robotic surgery by using the high dissection and low ligation technique.

Methods

Between October 2013 and August 2015, 50 patients with rectal cancer underwent robotic surgery after preoperative CCRT at a single institution. We performed D3 lymph node dissection and low tie ligation of the inferior mesenteric artery (IMA); this technique is referred to as the high dissection and low ligation technique. Clinicopathological features, perioperative parameters, and postoperative outcomes were retrospectively analyzed.

Results

FOLFOX regimen was used for preoperative CCRT in 26 (52 %) patients. Long-course radiotherapy was concurrently administered. A pathological complete response (pCR) was obtained in 14 (28 %) patients. Of the 50 patients, 23 (46 %) patients received intersphincteric resection (ISR) with coloanal anastomosis, 25 (50 %) patients received lower anterior resection (LAR), and 2 (4 %) patients received abdominoperineal resection (APR). Apical nodes were pathologically harvested in 47 (94 %) patients, and the median number of harvested apical lymph nodes was 2 (range, 0–10). The overall complication rate was 24 % (10 patients with 12 episodes), and most complications were mild.

Conclusion

Roboic rectal surgery combined with appropriate preoperative CCRT helps in achieving a favorable pCR, circumferential resection margin, and sphincter preservation. Moreover, high dissection and low ligation of the IMA can be safely performed using the da Vinci^® Surgical System safely which yield favorable short-term clinical outcomes.

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Title: Robotic surgery with high dissection and low ligation technique for consecutive patients with rectal cancer following preoperative concurrent chemoradiotherapy
Authors: Ching-Wen Huang
Yung-Sung Yeh
Wei-Chih Su
Hsiang-Lin Tsai
Tak-Kee Choy
Ming-Yii Huang
Chun-Ming Huang
I-Chen Wu
Huang-Ming Hu
Wen-Hung Hsu
Yu-Chung Su
Jaw-Yuan Wang
Publication date: 01-06-2016
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 6/2016
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-016-2581-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Robotic surgery with high dissection and low ligation technique for consecutive patients with rectal cancer following preoperative concurrent chemoradiotherapy

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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