Comparison of short-term outcomes between robotic-assisted and laparoscopic proctectomy for rectal cancer: a case-control study

Abstract

Objective The role of robotic-assisted proctectomy for the treatment of rectal cancer has not been well-defined.This study aimed to compare the short-term outcomes of the first 33 consecutive robotic proctectomy performed in our unit with matched series of laparoscopic proctectomy. Methods From Nov2013 to Sept 2014, 33 cases with rectal cancer(≤15 cm from the anal verge)underwent robotic proctectomy in our institution.Patients treated with laparoscopic proctectomy, matched for age, sex, body mass index, tumor location and TNM staging with those undergoing robotic proctectomy were selected as controls. Results The operating times were longer in the robotic group than in the laparoscopic group(168.0±39.0 vs 148.5±40.2 min, P=0.05). The blood loss was significantly less in the robotic group than that in the laparoscopic group(89.1±44.5 vs 116.7±60.8 ml, P=0.04). The number of retrieved lymph node and the distal resection margin were similar between two groups.The circumferential margin was negative in all the patients.No conversion was necessary in two groups.Compared to the laparoscope, the times to first flatus passage and the times to remove a urinary catheter were significantly shorter in the robotic group(53.3±15.4 vs 62.5±11.9 hrs, 3.0±0.9 vs 4.8±0.9 days, P<0.01). The 24-hour pain scores in the robotic group were significantly less than those in the laparoscopic group.During an average followup of 124 days(range 6-302 days), both groups had one case with anastomotic leakage, which was successfully managed by conservative therapy. Conclusion Our initial experience suggests that a robotic proctectomy is a safe procedure for patients with rectal cancer.The short-term outcomes of the robotic proctectomy are better than those of the laparoscopic proctectomy in terms of blood loss, recovery of bowel and urinary function.The long-term oncologic outcomes need further evaluation. Key words: Laparoscopes; Robotic-assisted surgery; Colorectal surgery; Rectal neoplasms