Robotic Versus Laparoscopic Versus Open Surgery for Rectal Cancer

Area of Science:

• Colorectal Surgery
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Rectal cancer treatment has advanced with minimally invasive and robotic surgical techniques.
• Evaluating robotic surgery's impact on perioperative and oncological outcomes is crucial.
• This study compares robotic, laparoscopic, and open surgery for rectal cancer.

Purpose of the Study:

• To compare robotic surgery with laparoscopic and open resection for rectal cancer.
• To assess differences in perioperative outcomes, including total mesorectal excision (TME) quality, operative time, and hospital stay.
• To evaluate oncological outcomes such as lymph node yield and 5-year survival rates.

Main Methods:

• A retrospective study of 212 rectal cancer patients (2012-2021).
• Patients were grouped by surgical approach: robotic (RR), laparoscopic (LR), and open resection (OR).
• Primary endpoints: TME quality, operative time, hospital stay. Secondary endpoints: lymph node yield, conversion rate, 5-year survival (OS, DFS).

Main Results:

• High TME quality across all groups (91.9% RR, 86.8% LR, 95.1% OR).
• Robotic surgery had longer operative times (304 min) but shorter hospital stays (10 days) and lower conversion rates (3.2%) compared to LR/OR.
• Fewer postoperative complications (pneumonia, bladder dysfunction) observed in robotic and laparoscopic groups versus open surgery. No significant difference in 5-year OS and DFS.

Conclusions:

• Robotic surgery for rectal cancer improves short-term outcomes, including reduced complications and hospitalization.
• Robotic surgery demonstrates comparable oncological efficacy to laparoscopic and open surgery for rectal cancer.
• Robotic approaches offer benefits in recovery and safety, despite longer operative times.