Multicentre study of robotic intersphincteric resection for low rectal cancer

Area of Science:

• Colorectal Surgery
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Limited data exists on the oncological safety of robotic intersphincteric resection (ISR) with coloanal anastomosis.
• This study aimed to evaluate the long-term feasibility of robotic versus laparoscopic ISR.

Purpose of the Study:

• To compare the oncological safety and long-term feasibility of robotic ISR against laparoscopic ISR for rectal cancer treatment.

Main Methods:

• A 1:1 case-matched cohort study included 212 patients (106 robotic, 106 laparoscopic) from seven institutions.
• Propensity score analysis was used to compare outcomes, with 3-year disease-free survival as the primary endpoint.

Main Results:

• Both robotic and laparoscopic ISR demonstrated similar 3-year local recurrence rates (6.7% vs. 5.7%) and disease-free survival (89.6% vs. 90.5%).
• Robotic ISR had higher mean hospital costs (€12,757 vs. €9223) and a trend towards fewer stomas at follow-up (2.8% vs. 8.5%).

Conclusions:

• Robotic ISR with coloanal anastomosis provides acceptable oncological outcomes for rectal cancer.
• The current high cost of robotic ISR, without clear short-term advantages, limits its widespread adoption.