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Feasibility of robotic platform to perform R0 resection for locally advanced multi-visceral pelvic malignancy: an institutional experience on outcomes of robotic pelvic exenteration

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Abstract

Background

Exenteration surgery for multi-visceral pelvic malignancy is a complex life-changing operation with high perioperative morbidity and mortality. Traditional open surgery has long been the standard approach for pelvic exenteration for achieving Ro resection which is the main aim of surgery. In the current era of minimally invasive surgery, robotic-assisted pelvic exenteration has provided a promising alternative, offering potential advantages in terms of improved oncological outcomes and enhanced postoperative recovery. This study aims to explore the feasibility of a robotic platform for locally advanced multi-visceral pelvic malignancy.

Methods

A retrospective review from the prospectively maintained robotic colorectal surgery database at University Hospital Coventry and Warwickshire (UHCW) Trust was performed. Demographic details and clinical and surgical details were documented from the case records. Data was analysed using SPSS version 22.

Results

Thirteen female patients diagnosed with primary or recurrent pelvic malignancy who underwent robotic pelvic exenteration at UHCW between February 2019 and April 2023 at UHCW were included. The mean age of our patients was 60.4 (± 10.1) years. Complete Ro resection was achieved in all 13 (100%) cases on final histopathology. The median length of hospital stay was 15 days after this extensive surgery. Grade 3 morbidity on Clavien–Dindo classification was observed in four (30.7%) patients, while zero percent 30-day mortality was experienced in this study. At a median follow-up of 21 (3–53) months, we observed tumor recurrence in three (23.7%) patients, while death in four (30.7%) patients. Only few studies have highlighted outcomes of robotic pelvic exenteration, and our results were quite comparable to them.

Conclusion

Robotic-assisted pelvic exenteration for primary or recurrent pelvic malignancy is feasible with improved oncological and acceptable postoperative outcomes.

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Abbreviations

ASA :

American Society of Anesthesiologists

DS :

Disease-free survival

OS :

Overall survival

MDT :

Multidisciplinary meeting

SPSS :

Statistical Package for the Social Sciences

UHCW :

University Hospital Coventry and Warwickshire

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Authors and Affiliations

  1. University Hospital Coventry and Warwickshire Trust, Coventry, UK

    Sabah Uddin Saqib, Muhammad Zeeshan Raza, Jeremy Twigg, Omer Altan & Adeel Ahmad Bajwa

Authors
  1. Sabah Uddin Saqib
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  2. Muhammad Zeeshan Raza
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  3. Jeremy Twigg
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  4. Omer Altan
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  5. Adeel Ahmad Bajwa
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Contributions

All authors contributed to the study’s conception and design. Material preparation, data collection, and analysis were performed by S.S. and Z.R. Data analysis was performed by S.S. The first draft of the manuscript was written by S.S., later amended by Z.R. J.T., O.A., and A.B. were robotic surgeons involved in care of patients and did the final editing. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Sabah Uddin Saqib.

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Not required as data was collected from files and patients were not directly involved.

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The authors declare no competing interests.

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Saqib, S.U., Raza, M.Z., Twigg, J. et al. Feasibility of robotic platform to perform R0 resection for locally advanced multi-visceral pelvic malignancy: an institutional experience on outcomes of robotic pelvic exenteration. Langenbecks Arch Surg 409, 9 (2024). https://doi.org/10.1007/s00423-023-03206-7

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