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Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
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Local recurrence of robot-assisted total mesorectal excision: a multicentre cohort study evaluating the initial cases
T A Burghgraef1,2, R M P H Crolla3, M Fahim4
1Department of Surgery, University Medical Centre Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands. t.a.burghgraef@umcg.nl.
International Journal of Colorectal Disease
|June 16, 2022
Summary
Robot-assisted surgery for rectal cancer shows low local recurrence rates during initial procedures. Experienced surgeons can safely implement this technique without increasing recurrence risks in early cases.
Area of Science:
- Oncology
- Surgical Innovation
- Gastrointestinal Surgery
Background:
- Robot-assisted total mesorectal excision (TME) is a minimally invasive technique for rectal cancer.
- Data on local recurrence rates during the initial learning curve for robot-assisted TME is limited.
- Assessing early outcomes is crucial for safe implementation.
Purpose of the Study:
- To evaluate local recurrence rates in the initial cases of robot-assisted TME across four Dutch centers.
- To compare outcomes between different phases of surgical experience.
Main Methods:
- Retrospective analysis of 531 patients undergoing robot-assisted TME for rectal carcinoma.
- Inclusion criteria: elective surgery with curative intent.
- Outcomes (overall survival, disease-free survival, recurrence) assessed at 3 years.
- Comparison of initial 10 cases, cases 11-40, and subsequent cases using Cox regression.
Main Results:
- Local recurrence was 4.9% in the first 10 cases and 6.6% in cases 11-40.
- No significant difference in local recurrence rates was found between case groups.
- Overall survival and disease-free survival were comparable across groups.
Conclusions:
- Robot-assisted TME demonstrates a low local recurrence rate during its initial implementation phase.
- The technique can be safely adopted by experienced laparoscopic surgeons.
- Early adoption does not appear to compromise oncological outcomes regarding local recurrence.
