Rectal cancer ; Total mesorectal excision ; Hand-assisted laparoscopic surgery ; Robotic surgery
Abstract
We compared short-term and long-term surgical and oncological outcomes of robotic surgery versus hand-assisted laparoscopic
surgery for rectal cancers patients. Study was conducted at the National Cancer Institute and Yonsei Cancer Centre from August
2006 to December 2012. We prospectively reviewed all patients who underwent RS and HALS for upper and middle third rectal
cancers. Patients’ demographics, postoperative short-term and long-term outcomes were assessed. Baseline patients’ characteristics were similar in both groups. Average operative time was 321.3 ± 70 min for robotic surgery versus 106.0 ± 37 min for handassisted laparoscopic surgery, P < 0.001). Higher number of patients (n = 74, 94.9%) with tumour in the upper rectum was found
in hand-assisted laparoscopic group (P < 0.01). Perioperative complications were more common in the robotic surgery group (9
vs. 5 patients). In all stages, 3-year overall survival was 86.9% in the hand-assisted laparoscopic group vs. 89.6% in the robotic
group: 80.0% vs. 79.2 for stage I and 82.4% vs. 88.9 for stage II and III. The 3-year DFS was 83.6% in hand-assisted laparoscopic
group vs. 83.2%—robotic surgery group considering all stages. Anastomotic leakage, bleeding, number of postoperative complications, overall survival and disease-free survival were similar and not much different between robotic and hand-assisted
laparoscopic rectal cancer surgery