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Long-Term Outcomes of Robotic Versus Laparoscopic Total Mesorectal Excisions: A Propensity-Score Matched Cohort study of 5-year survival outcomes

  • 0From the Department of Colorectal Surgery, Portsmouth Hospitals University NHS Trust, Portsmouth, UK.
Annals of Surgery Open : Perspectives of Surgical History, Education, and Clinical Approaches +

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June 24, 2024

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June 24, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Robotic rectal cancer surgery demonstrated higher 5-year overall survival compared to laparoscopic surgery. Robotic total mesorectal excision (TME) offers improved short-term outcomes, making it a favorable alternative for rectal cancer treatment.

Area Of Science

  • Oncology
  • Surgical Innovation
  • Gastrointestinal Surgery

Background

  • Laparoscopic surgery for rectal cancer offers short-term benefits over open procedures but has technical limitations.
  • Robotic surgery aims to overcome the technical challenges associated with laparoscopic rectal cancer resections.
  • Comparing long-term oncological and short-term surgical outcomes between laparoscopic and robotic total mesorectal excision (TME) is crucial.

Purpose Of The Study

  • To compare the long-term outcomes of laparoscopic versus robotic total mesorectal excisions (TMEs) for rectal cancer.
  • To evaluate differences in overall survival, recurrence rates, and disease-free survival between the two surgical approaches.
  • To assess short-term surgical and patient-related outcomes, including conversion rates, length of stay, and postoperative complications.

Main Methods

  • A retrospective study included patients who underwent laparoscopic or robotic TME for rectal cancer between 2013 and 2021.
  • Propensity-score matching was used to create comparable groups for analysis.
  • Primary outcome was 5-year overall survival (OS); secondary outcomes included local recurrence (LR), distant recurrence (DR), disease-free survival (DFS), and short-term surgical outcomes.

Main Results

  • After matching, 215 patients were in each group. Robotic TME showed significantly higher 5-year OS (81.7%) versus laparoscopy (72.4%, P=0.029).
  • No significant differences were observed in 5-year local recurrence (4.7% vs 5.2%), distant recurrence (16.9% vs 13.5%), or DFS (63.9% vs 74.4%).
  • The robotic group experienced significantly lower conversion rates (0.5% vs 3.7%), shorter length of stay (6 vs 7 days), and fewer postoperative complications (50.7% vs 63.5%).

Conclusions

  • Robotic TME is associated with improved 5-year overall survival and comparable long-term oncological outcomes to laparoscopic TME for rectal cancer.
  • Robotic surgery offers significant advantages in reduced conversion rates, shorter hospital stays, and fewer postoperative complications.
  • Robotic rectal cancer surgery represents a safe and advantageous alternative to traditional laparoscopic approaches.

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