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Robotic versus laparoscopic coloanal anastomosis with or without intersphincteric resection for rectal cancer

Authors
 Se Jin Baek  ;  Sami AL-Asari  ;  Duck Hyoun Jeong  ;  Hyuk Hur  ;  Byung Soh Min  ;  Seung Hyuk Baik  ;  Nam Kyu Kim 
Citation
 SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol.27(11) : 4157-4163, 2013 
Journal Title
 SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES 
ISSN
 0930-2794 
Issue Date
2013
MeSH
Adenocarcinoma/mortality ; Adenocarcinoma/pathology ; Adenocarcinoma/secondary ; Adenocarcinoma/surgery* ; Anal Canal/surgery* ; Anastomosis, Surgical/adverse effects ; Anastomosis, Surgical/methods ; Colonoscopy ; Conversion to Open Surgery/statistics & numerical data ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Laparoscopy*/adverse effects ; Length of Stay/statistics & numerical data ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Recurrence, Local/epidemiology ; Neoplasm Staging ; Prospective Studies ; Rectal Neoplasms/mortality ; Rectal Neoplasms/pathology ; Rectal Neoplasms/surgery* ; Retrospective Studies ; Robotics* ; Treatment Outcome
Keywords
Adenocarcinoma/mortality ; Adenocarcinoma/pathology ; Adenocarcinoma/secondary ; Adenocarcinoma/surgery* ; Anal Canal/surgery* ; Anastomosis, Surgical/adverse effects ; Anastomosis, Surgical/methods ; Colonoscopy ; Conversion to Open Surgery/statistics & numerical data ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Laparoscopy*/adverse effects ; Length of Stay/statistics & numerical data ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Recurrence, Local/epidemiology ; Neoplasm Staging ; Prospective Studies ; Rectal Neoplasms/mortality ; Rectal Neoplasms/pathology ; Rectal Neoplasms/surgery* ; Retrospective Studies ; Robotics* ; Treatment Outcome
Abstract
Robotic surgery is increasingly used in the field of rectal cancer surgery. This study aimed to compare the short- and long-term outcomes between robotic and laparoscopic ultralow anterior resection (uLAR) and coloanal anastomosis (CAA). Between January 2007 and December 2010, a retrospective chart review was performed for all patients with low rectal cancer who underwent curative uLAR and CAA with or without intersphincteric resection using either a robotic or a laparoscopic approach. The study excluded patients with tumors invading the levator ani or external sphincter, patients with T4 cancers invading the prostate or vagina, and patients for whom an open approach was used. Patients' short- and long-term outcomes were evaluated. This study enrolled 84 consecutive patients (47 in the robotic group and 37 in the laparoscopic group). The patient characteristics and operative data did not differ significantly between the groups except for the rate of conversion to open surgery (robot, 2.1 % vs laparoscopy, 16.2 %; p = 0.02). The postoperative outcomes also were similar in the two groups, but the hospital stay was shorter in the robotic group than in the laparoscopic group (robot, 9 days vs laparoscopy, 11 days; p = 0.011). No postoperative mortality occurred. The median follow-up period was 31.5 months. No difference was shown in local recurrence, 3-year overall survival, or disease-free survival between the two groups. Robotic uLAR and CAA with or without ISR is a safe and feasible surgical approach with a lower conversion rate, a shorter hospital stay, and similar oncologic outcomes compared with a laparoscopic approach. Further prospective and case-control cohort studies with longer follow-up periods are required.
Full Text
http://link.springer.com/article/10.1007%2Fs00464-013-3014-4
DOI
10.1007/s00464-013-3014-4
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Min, Byung Soh(민병소) ORCID logo https://orcid.org/0000-0003-0180-8565
Baek, Se Jin(백세진)
Baik, Seung Hyuk(백승혁) ORCID logo https://orcid.org/0000-0003-4183-2332
Jeong, Duck Hyoun(정덕현)
Hur, Hyuk(허혁) ORCID logo https://orcid.org/0000-0002-9864-7229
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/88520
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