Abstract
Purpose
Although robotic surgery for rectal cancer can overcome the shortcomings of laparoscopic surgery, studies focusing on abdominoperineal resection are limited. The aim of this study was to compare the operative outcomes between robotic and laparoscopic abdominoperineal resection.
Methods
This retrospective cohort study was conducted from April 2010 to March 2020. Patients with rectal cancer who underwent robotic or laparoscopic abdominoperineal resection without lateral lymph node dissection were enrolled. The perioperative and oncological outcomes were compared.
Results
We evaluated 33 and 20 patients in the robotic and laparoscopic groups, respectively. The median operative time and blood loss were comparable between the two groups. No significant differences in the overall complication rates were noted, whereas the rates of urinary dysfunction (3% vs. 26%, p = 0.02) and perineal wound infection (9% vs. 35%, p = 0.03) in the robotic group were significantly lower in comparison to the laparoscopic group. The median postoperative hospital stay was significantly shorter in the robotic group (8 days vs. 11 days, p < 0.01). The positive resection margin rates were comparable between the two groups.
Conclusion
Robotic abdominoperineal resection demonstrated better short-term outcomes than laparoscopic surgery, suggesting that it could be a useful approach.
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Acknowledgements
We wish to thank Takanori Kawabata, a biostatistician, for providing advice on the statistical analyses. We are grateful to Reiko Suzuki for her narration of Online Resource 1.
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Online Resource 1: Dissection of the levator ani muscle in robotic abdominoperineal resection Robotic surgery typically enables dissection of the levator ani muscle in abdominoperineal resection. Reaching the ischiorectal fossa as deeply as possible in the abdominopelvic procedure allows better access for perineal dissection (MPG 5434 KB)
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Kasai, S., Kagawa, H., Shiomi, A. et al. Advantages of robotic abdominoperineal resection compared with laparoscopic surgery: a single-center retrospective study. Surg Today 52, 643–651 (2022). https://doi.org/10.1007/s00595-021-02359-6
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DOI: https://doi.org/10.1007/s00595-021-02359-6