Outcomes of Robotic versus Laparoscopic versus Open Resection for Rectal Cancer in a Center with a Beginning Robotic...

Area of Science:

• Colorectal Surgery
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Robotic surgery for rectal cancer is an emerging field in the Philippines.
• Robot-assisted (R) rectal surgery demonstrates promising results compared to laparoscopic (L) and open (O) approaches.

Purpose of the Study:

• To compare the clinicopathologic outcomes of robotic rectal resections with laparoscopic and open resections.
• To evaluate the initial experience of robotic rectal surgery at the Philippine General Hospital (PGH).

Main Methods:

• A retrospective cohort study of 45 consecutive rectal resections (15 R, 15 L, 15 O) from March to October 2019.
• Statistical analysis included one-way ANOVA and Bonferroni multiple comparison tests.

Main Results:

• Robotic surgery had the longest operative time and highest blood loss. Open surgery had the shortest post-operative length of stay.
• No conversions to open surgery were noted in the robotic or laparoscopic groups. Post-operative ileus was most common in the robotic group.
• R0 resection rates were 100% for open and laparoscopic, but lower for robotic (69.23%). Circumferential resection margins were negative in all open cases.

Conclusions:

• The initial outcomes of robotic rectal surgery at PGH are promising, despite a learning curve.
• Further experience is anticipated to yield more favorable clinicopathological results.