Does robotic TME bring difference in lymph node yield and quality of TME?

Area of Science:

• Surgical Oncology
• Gastrointestinal Surgery
• Robotic Surgery

Background:

• The oncological outcomes of robotic low anterior rectal resection with total mesorectal excision (rTME) require further investigation.
• While rTME is considered safe and equivalent for rectal carcinoma, direct comparisons with conventional TME regarding lymph node yield and TME quality are limited.

Purpose of the Study:

• To compare the number of lymph nodes obtained between robotic TME (rTME) and conventional TME (TME).
• To evaluate and compare the quality of TME and the rate of positive circumferential resection margins between rTME and TME, with or without neoadjuvant chemoradiation (nCHRT).

Main Methods:

• A retrospective study of 261 patients undergoing rectal resection.
• Patients were stratified by surgical approach (rTME vs. TME) and neoadjuvant chemoradiation status (nCHRT vs. no nCHRT).
• Primary endpoint was lymph node yield; secondary endpoints included TME quality and margin positivity.

Main Results:

• No significant difference was observed in the number of lymph nodes retrieved between the rTME and TME groups.
• TME quality was comparable between both surgical approaches, irrespective of prior nCHRT.

Conclusions:

• Robotic TME (rTME) is demonstrated to be non-inferior to conventional TME for rectal cancer surgery.
• Equivalent oncological outcomes, including lymph node harvest and TME quality, can be expected with rTME compared to conventional TME.