Abstract

BackgroundTherapeutic strategies to suppress local recurrence, including lateral lymph node metastasis, are important to improve the curability of rectal cancer. The aim of the present study was to clarify the advantages of robotic-assisted laparoscopic lateral lymph node dissection (RALLD), comparing its short-term outcomes with those of laparoscopic lateral lymph node dissection (LLLD). There are some retrospective reports comparing RALLD or LLLD and open lateral lymph node dissection (OLLD), but few reports comparing RALLD and LLND to each other.MethodsFrom November 2014 to August 2020, we compared the short-term outcomes in 40 patients who underwent RALLD and 55 patients who underwent LLLD.ResultsThe total operative time was significantly longer in the RALLD group than in the LLLD group (p < 0.001). However, lateral dissection time was not significantly different between the groups (p = 0.661). The postoperative hospital time was shorter in the RALLD group than in the LLLD group (p < 0.048). No significant differences were identified in the rates of postoperative bleeding, incisional surgical site infection (SSI), organ/space SSI, urinary disfunction, urinary infection, or small bowel obstruction between the groups. However, anastomotic leakage was significantly lower in the RALLD group than in the LLLD group (p = 0.031).ConclusionsThe short-term outcomes of RALLD indicate it is feasible, and RALLD may be a useful modality for lower rectal cancer.

Highlights

  • Therapeutic strategies to suppress local recurrence, including lateral lymph node metastasis, are important to improve the curability of rectal cancer

  • The rate of neoadjuvant chemotherapy (NAC) was higher in the robotic-assisted laparoscopic lateral lymph node dissection (RALLD) group than in the lateral lymph node dissection (LLLD) group

  • Total operative time was significantly longer in the RALLD group than in the LLLD group (p < 0.001)

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Summary

Introduction

Therapeutic strategies to suppress local recurrence, including lateral lymph node metastasis, are important to improve the curability of rectal cancer. There are some retrospective reports comparing RALLD or LLLD and open lateral lymph node dissection (OLLD), but few reports comparing RALLD and LLND to each other. Methods From November 2014 to August 2020, we compared the short-term outcomes in 40 patients who underwent RALLD and 55 patients who underwent LLLD. Results The total operative time was significantly longer in the RALLD group than in the LLLD group (p < 0.001). Lateral dissection time was not significantly different between the groups (p = 0.661). The postoperative hospital time was shorter in the RALLD group than in the LLLD group (p < 0.048). Anastomotic leakage was significantly lower in the RALLD group than in the LLLD group (p = 0.031). Conclusions The short-term outcomes of RALLD indicate it is feasible, and RALLD may be a useful modality for lower rectal cancer

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