Oncological and Functional Outcomes After Minimally Invasive Surgery for Mid and Low Rectal Adenocarcinoma: A Review

In this study, we analyze the oncological and functional outcomes after minimally invasive surgery (laparoscopic and robotic) for mid and low rectal adenocarcinoma. This is a narrative review of articles published from January 2019 to December 2024 in which we analyzed the rate of short-term oncological outcomes (quality of surgical samples), long-term oncological outcomes (recurrence rate, overall survival, and disease-free survival), and functional disorders (urinary, sexual, and bowel function) after minimally invasive surgery. The rates of complete mesorectum are 67.7%-92.8%, the rate of free circumferential resection margin is 94%-98.2%, and the rate of free distal resection margin is 99.4%-100%. The local recurrence rate is 2.3%-7.3%, the overall survival rate is 80%-95.6%, and the disease-free survival rate is 70%-86.4%. The rate of urinary disorders is 25%-26.5%, sexual disorders are 35%-80%, and bowel disorders are 17%-44.6%. This review demonstrates that minimally invasive surgery yields favorable oncological and functional outcomes. The continuous evolution in robotic surgery will increasingly lead to interesting implications for rectal surgery, thanks to less surgical trauma and better intraoperative visualization of nerves.