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Total mesorectal excision for mid and low rectal cancer: Laparoscopic vs robotic surgery.
World J Gastroenterol. 2016 Apr 07; 22(13):3602-10.WJ

Abstract

AIM

To compare the short- and long-term outcomes of laparoscopic and robotic surgery for middle and low rectal cancer.

METHODS

This is a retrospective study on a prospectively collected database containing 111 patients who underwent minimally invasive rectal resection with total mesorectal excision (TME) with curative intent between January 2008 and December 2014 (robot, n = 53; laparoscopy, n = 58). The patients all had a diagnosis of middle and low rectal adenocarcinoma with stage I-III disease. The median follow-up period was 37.4 mo. Perioperative results, morbidity a pathological data were evaluated and compared. The 3-year overall survival and disease-free survival rates were calculated and compared.

RESULTS

Patients were comparable in terms of preoperative and demographic parameters. The median surgery time was 192 min for laparoscopic TME (L-TME) and 342 min for robotic TME (R-TME) (P < 0.001). There were no differences found in the rates of conversion to open surgery and morbidity. The patients who underwent laparoscopic surgery stayed in the hospital two days longer than the robotic group patients (8 d for L-TME and 6 d for R-TME, P < 0.001). The pathologic evaluation showed a higher number of harvested lymph nodes in the robotic group (18 for R-TME, 11 for L-TME, P < 0.001) and a shorter distal resection margin for laparoscopic patients (1.5 cm for L-TME, 2.5 cm for R-TME, P < 0.001). The three-year overall survival and disease-free survival rates were similar between groups.

CONCLUSION

Both L-TME and R-TME achieved acceptable clinical and oncologic outcomes. The robotic technique showed some advantages in rectal surgery that should be validated by further studies.

Authors+Show Affiliations

Francesco Feroci, Andrea Vannucchi, Stefano Cantafio, Alessia Garzi, Marco Scatizzi, Department of General and Oncological Surgery, Santo Stefano Hospital, 59100 Prato, Italy.Francesco Feroci, Andrea Vannucchi, Stefano Cantafio, Alessia Garzi, Marco Scatizzi, Department of General and Oncological Surgery, Santo Stefano Hospital, 59100 Prato, Italy.Francesco Feroci, Andrea Vannucchi, Stefano Cantafio, Alessia Garzi, Marco Scatizzi, Department of General and Oncological Surgery, Santo Stefano Hospital, 59100 Prato, Italy.Francesco Feroci, Andrea Vannucchi, Stefano Cantafio, Alessia Garzi, Marco Scatizzi, Department of General and Oncological Surgery, Santo Stefano Hospital, 59100 Prato, Italy.Francesco Feroci, Andrea Vannucchi, Stefano Cantafio, Alessia Garzi, Marco Scatizzi, Department of General and Oncological Surgery, Santo Stefano Hospital, 59100 Prato, Italy.Francesco Feroci, Andrea Vannucchi, Stefano Cantafio, Alessia Garzi, Marco Scatizzi, Department of General and Oncological Surgery, Santo Stefano Hospital, 59100 Prato, Italy.Francesco Feroci, Andrea Vannucchi, Stefano Cantafio, Alessia Garzi, Marco Scatizzi, Department of General and Oncological Surgery, Santo Stefano Hospital, 59100 Prato, Italy.

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27053852

Citation

Feroci, Francesco, et al. "Total Mesorectal Excision for Mid and Low Rectal Cancer: Laparoscopic Vs Robotic Surgery." World Journal of Gastroenterology, vol. 22, no. 13, 2016, pp. 3602-10.
Feroci F, Vannucchi A, Bianchi PP, et al. Total mesorectal excision for mid and low rectal cancer: Laparoscopic vs robotic surgery. World J Gastroenterol. 2016;22(13):3602-10.
Feroci, F., Vannucchi, A., Bianchi, P. P., Cantafio, S., Garzi, A., Formisano, G., & Scatizzi, M. (2016). Total mesorectal excision for mid and low rectal cancer: Laparoscopic vs robotic surgery. World Journal of Gastroenterology, 22(13), 3602-10. https://doi.org/10.3748/wjg.v22.i13.3602
Feroci F, et al. Total Mesorectal Excision for Mid and Low Rectal Cancer: Laparoscopic Vs Robotic Surgery. World J Gastroenterol. 2016 Apr 7;22(13):3602-10. PubMed PMID: 27053852.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Total mesorectal excision for mid and low rectal cancer: Laparoscopic vs robotic surgery. AU - Feroci,Francesco, AU - Vannucchi,Andrea, AU - Bianchi,Paolo Pietro, AU - Cantafio,Stefano, AU - Garzi,Alessia, AU - Formisano,Giampaolo, AU - Scatizzi,Marco, PY - 2015/12/16/received PY - 2016/01/27/revised PY - 2016/02/22/accepted PY - 2016/4/8/entrez PY - 2016/4/8/pubmed PY - 2017/1/18/medline KW - Laparoscopic surgery KW - Minimally invasive surgery KW - Rectal cancer KW - Robotic surgery KW - Total mesorectal excision SP - 3602 EP - 10 JF - World journal of gastroenterology JO - World J. Gastroenterol. VL - 22 IS - 13 N2 - AIM: To compare the short- and long-term outcomes of laparoscopic and robotic surgery for middle and low rectal cancer. METHODS: This is a retrospective study on a prospectively collected database containing 111 patients who underwent minimally invasive rectal resection with total mesorectal excision (TME) with curative intent between January 2008 and December 2014 (robot, n = 53; laparoscopy, n = 58). The patients all had a diagnosis of middle and low rectal adenocarcinoma with stage I-III disease. The median follow-up period was 37.4 mo. Perioperative results, morbidity a pathological data were evaluated and compared. The 3-year overall survival and disease-free survival rates were calculated and compared. RESULTS: Patients were comparable in terms of preoperative and demographic parameters. The median surgery time was 192 min for laparoscopic TME (L-TME) and 342 min for robotic TME (R-TME) (P < 0.001). There were no differences found in the rates of conversion to open surgery and morbidity. The patients who underwent laparoscopic surgery stayed in the hospital two days longer than the robotic group patients (8 d for L-TME and 6 d for R-TME, P < 0.001). The pathologic evaluation showed a higher number of harvested lymph nodes in the robotic group (18 for R-TME, 11 for L-TME, P < 0.001) and a shorter distal resection margin for laparoscopic patients (1.5 cm for L-TME, 2.5 cm for R-TME, P < 0.001). The three-year overall survival and disease-free survival rates were similar between groups. CONCLUSION: Both L-TME and R-TME achieved acceptable clinical and oncologic outcomes. The robotic technique showed some advantages in rectal surgery that should be validated by further studies. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/27053852/Total_mesorectal_excision_for_mid_and_low_rectal_cancer:_Laparoscopic_vs_robotic_surgery_ L2 - http://www.wjgnet.com/1007-9327/full/v22/i13/3602.htm DB - PRIME DP - Unbound Medicine ER -