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Updated: May 14, 2026
Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
Oncologic outcomes and perioperative clinicopathologic results after robot-assisted tumor-specific mesorectal
Seung Hyuk Baik1, Nam Kyu Kim, Dae Ro Lim
1Section of Colon Rectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea.
Background:
Robot-assisted surgery is a new and emerging surgical procedure for rectal cancer patients. However, there is a lack of information regarding oncologic outcomes for this procedure. We aimed to evaluate oncologic and perioperative clinicopathologic outcomes of surgical resection using robotic instruments for rectal cancer.
Methods:
Data from rectal cancer patients (n = 370) diagnosed with stage I-IV disease sited below 15 cm from the anal verge who underwent robot-assisted tumor-specific mesorectal excision consecutively from June 2006 to December 2010 were evaluated. Clinicopathologic and follow-up data were recorded prospectively and analyzed retrospectively. Perioperative clinicopathologic outcomes, postoperative complications, 3-year overall survival rate, and 3-year disease-free survival rate were analyzed.
Results:
All patients underwent robot-assisted tumor-specific mesorectal excision. Of all postoperative pathologic stages, 15 (4.1 %) were stage 0 (pathologic complete remission), 126 (34.1 %) stage I, 95 (25.7 %) stage II, 118 (31.9 %) stage III, and 16 (4.3 %) stage IV. The 3-year overall survival rate was 93.1 % (pathologic complete remission = 100 %, stage I = 99.2 %, stage II = 97.1 %, stage III = 90.1 %, and stage IV = 48.4 %). The 3-year disease-free survival rate was 79.2 % (pathologic complete remission = 100 %, stage I = 93.7 %, stage II = 79.8 %, stage III = 69.6 %, and stage IV = 0.0 %). The 3-year cumulative local recurrence rate was 3.6 % (n = 10). The circumferential resection margin positive rate was 5.7 % (n = 21). Local recurrence developed in one patient and systemic recurrence developed in five patients. The total number of patients with postoperative complications was 86 (23.2 %).
Conclusions:
These data show the feasibility and safety of robot-assisted tumor-specific mesorectal excision for rectal cancer in terms of oncologic outcomes.
Insights
Robot-assisted surgery for rectal cancer demonstrates feasibility and safety, with promising oncologic outcomes. This minimally invasive approach shows good survival rates and low recurrence for patients with various disease stages.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Rectal Cancer Treatment
Background:
- Robot-assisted surgery is an emerging technique for rectal cancer.
- Limited data exists on the oncologic outcomes of this procedure.
- This study evaluates the safety and efficacy of robotic rectal cancer resection.
Purpose of the Study:
- To assess the oncologic and perioperative outcomes of robot-assisted tumor-specific mesorectal excision for rectal cancer.
- To provide data on survival rates, recurrence, and complications.
- To establish the feasibility and safety of this surgical approach.
Main Methods:
- Retrospective analysis of prospectively collected data from 370 rectal cancer patients (Stage I-IV).
- Patients underwent robot-assisted tumor-specific mesorectal excision between June 2006 and December 2010.
- Outcomes analyzed include clinicopathologic data, postoperative complications, 3-year overall survival, and 3-year disease-free survival.
Main Results:
- The 3-year overall survival rate was 93.1%, with higher rates for earlier stages.
- The 3-year disease-free survival rate was 79.2%.
- The cumulative local recurrence rate was 3.6%, and the positive circumferential resection margin rate was 5.7%.
Conclusions:
- Robot-assisted tumor-specific mesorectal excision is a feasible and safe procedure for rectal cancer.
- The technique yields acceptable oncologic outcomes.
- Further research can build upon these findings to optimize robotic rectal cancer treatment.
