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Robotic versus laparoscopic rectal resection for sphincter-saving surgery: pathological and short-term outcomes in a single-center analysis of 130 consecutive patients.
Surg Endosc. 2017 10; 31(10):4085-4091.SE

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.

Authors+Show Affiliations

Service de Chirurgie Digestive, Groupe Hospitalier Diaconesses Croix Saint Simon, 125, rue d'Avron, 75020, Paris, France.Service de Chirurgie Digestive, Groupe Hospitalier Diaconesses Croix Saint Simon, 125, rue d'Avron, 75020, Paris, France.Service de Chirurgie Digestive, Groupe Hospitalier Diaconesses Croix Saint Simon, 125, rue d'Avron, 75020, Paris, France.Service d'Anatomie Pathologique, Hôpital Saint Antoine, Paris, France. University Paris VI, Paris, France.Service d'Anatomie Pathologique, Hôpital Saint Antoine, Paris, France. University Paris VI, Paris, France.Service de Chirurgie Digestive, Groupe Hospitalier Diaconesses Croix Saint Simon, 125, rue d'Avron, 75020, Paris, France.Service de Chirurgie Digestive, Groupe Hospitalier Diaconesses Croix Saint Simon, 125, rue d'Avron, 75020, Paris, France.Service de Chirurgie Digestive, Groupe Hospitalier Diaconesses Croix Saint Simon, 125, rue d'Avron, 75020, Paris, France.Service de Chirurgie Digestive, Groupe Hospitalier Diaconesses Croix Saint Simon, 125, rue d'Avron, 75020, Paris, France. rmlupinacci@gmail.com.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

28271268

Citation

Valverde, Alain, et al. "Robotic Versus Laparoscopic Rectal Resection for Sphincter-saving Surgery: Pathological and Short-term Outcomes in a Single-center Analysis of 130 Consecutive Patients." Surgical Endoscopy, vol. 31, no. 10, 2017, pp. 4085-4091.
Valverde A, Goasguen N, Oberlin O, et al. Robotic versus laparoscopic rectal resection for sphincter-saving surgery: pathological and short-term outcomes in a single-center analysis of 130 consecutive patients. Surg Endosc. 2017;31(10):4085-4091.
Valverde, A., Goasguen, N., Oberlin, O., Svrcek, M., Fléjou, J. F., Sezeur, A., Mosnier, H., Houdart, R., & Lupinacci, R. M. (2017). Robotic versus laparoscopic rectal resection for sphincter-saving surgery: pathological and short-term outcomes in a single-center analysis of 130 consecutive patients. Surgical Endoscopy, 31(10), 4085-4091. https://doi.org/10.1007/s00464-017-5455-7
Valverde A, et al. Robotic Versus Laparoscopic Rectal Resection for Sphincter-saving Surgery: Pathological and Short-term Outcomes in a Single-center Analysis of 130 Consecutive Patients. Surg Endosc. 2017;31(10):4085-4091. PubMed PMID: 28271268.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Robotic versus laparoscopic rectal resection for sphincter-saving surgery: pathological and short-term outcomes in a single-center analysis of 130 consecutive patients. AU - Valverde,Alain, AU - Goasguen,Nicolas, AU - Oberlin,Olivier, AU - Svrcek,Magali, AU - Fléjou,Jean-François, AU - Sezeur,Alain, AU - Mosnier,Henri, AU - Houdart,Rémi, AU - Lupinacci,Renato M, Y1 - 2017/03/07/ PY - 2016/09/19/received PY - 2017/02/03/accepted PY - 2017/3/9/pubmed PY - 2018/6/13/medline PY - 2017/3/9/entrez KW - Laparoscopy KW - Minimally invasive surgical procedures KW - Rectal cancer KW - Robotics SP - 4085 EP - 4091 JF - Surgical endoscopy JO - Surg Endosc VL - 31 IS - 10 N2 - 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. SN - 1432-2218 UR - https://www.unboundmedicine.com/medline/citation/28271268/Robotic_versus_laparoscopic_rectal_resection_for_sphincter_saving_surgery:_pathological_and_short_term_outcomes_in_a_single_center_analysis_of_130_consecutive_patients_ L2 - https://dx.doi.org/10.1007/s00464-017-5455-7 DB - PRIME DP - Unbound Medicine ER -