Open, laparoscopic, and robotic surgery for rectal cancer: medium-term comparative outcomes from a multicenter study

Area of Science:

• Oncology
• Surgical Innovation
• Minimally Invasive Surgery

Background:

• Laparoscopic surgery (LS) and open surgery (OS) are established treatments for rectal cancer, with demonstrated oncologic equivalence.
• LS can present significant surgical challenges.
• Robotic surgery (RS) offers potential advantages over both LS and OS.

Purpose of the Study:

• To evaluate the clinicopathologic outcome advantages of robotic surgery (RS) compared to open surgery (OS) and laparoscopic surgery (LS) for rectal cancer.
• To assess the feasibility and safety of RS in rectal cancer treatment.

Main Methods:

• A comparative study of 160 rectal cancer patients undergoing OS, RS, or LS between April 2009 and August 2011.
• Data collected included perioperative clinicopathologic variables, postoperative complications, and 3-year overall and disease-free survival (DFS) rates.
• Evaluations were conducted across 4 Italian hospitals.

Main Results:

• No significant differences in complication rates or surgical specimen evaluation quality were observed among the three surgical groups.
• Robotic surgery (RS) and laparoscopic surgery (LS) resulted in shorter hospital stays compared to open surgery (OS).
• Median follow-up was 33 months, with no significant differences in overall or disease-free survival (DFS) rates.

Conclusions:

• Robotic surgery (RS) is a feasible and safe approach for rectal cancer treatment, demonstrating comparable perioperative clinicopathologic and medium-term outcomes.
• While RS requires a longer operative time than LS and OS, its safety and efficacy are supported by the study findings.
• RS offers comparable oncologic outcomes and shorter hospital stays, positioning it as a viable alternative in rectal cancer surgery.