Robot-assisted rectal cancer surgery: short-term outcomes for 113 consecutive patients

The purpose of this study was to assess the short-term outcome of robot-assisted laparoscopic surgery (RALS) for rectal cancer, including robotic, autonomic nerve-preserving, lateral lymph node dissection (RALLD), a new, technically challenging procedure.

Between December 2011 and August 2013, 113 consecutive patients underwent RALS for rectal cancer. Surgical outcomes, pathological results, and postoperative complications were prospectively collected.

There were 78 males and 35 females; 30 patients (26.5%) had cT1 tumor, 14 (12.4%) had cT2, 56 (49.6%) had cT3, and 12 (10.6%) had cT4 tumor. The types of procedures performed were 82 anterior resections, 23 intersphincteric resections, and 8 abdominoperineal resections. RALLD was performed in 38 patients (33.6%). The overall median operative time was 302 (135-683) min. In cases without RALLD, the median operative time was 242 (135-529) min, while median operative time was 486 (320-683) min with RALLD. None of the cases was converted to an open or laparoscopic procedure. There was no surgical mortality. The overall complication rate for Clavien-Dindo classification grade III-IV was 2.7%. Ten patients who developed urinary retention recovered completely within 30 days after the operation.

RALS for rectal cancer is a technically feasible, less invasive procedure. This procedure can be performed with low morbidity and a low conversion rate, even for cases with advanced rectal cancer requiring complicated, robot-assisted, lateral lymph node dissection.