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Efficacy and Safety of Robotic Surgery for Bulky Colorectal Tumors
Hiroshi Maruta1, Keisuke Noda1, Tetsuro Tominaga2
1Division of Surgical Oncology, Department of Surgery, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan.
Background/Aim:
The management of bulky tumors (>80 mm) is technically challenging via laparoscopic surgery with high incidence of open conversion. The aim of this study was to evaluate the safety and efficacy of robotic surgery for bulky colorectal tumors.
Patients And Methods:
A total of 317 patients from seven hospitals (Nagasaki, Japan) with bulky colorectal cancer who underwent surgery between 2016 and 2024 were eligible for inclusion. The patients were divided into three groups: robotic surgery group (R group, n=18), laparoscopic surgery group (L group, n=234), and open surgery group (O group, n=65).
Results:
In the R group, rectal cancer was more common (61.1% vs. 14.1% vs. 10.8%, p<0.001), operation time was longer (363 vs. 259 vs. 210 min, p<0.001), blood loss was less (44 vs. 39 vs. 185 ml, p=0.018), and hospital stay was shorter (15 vs. 14 vs. 19 days, p=0.044) compared with the L and O groups, respectively. Conversion to open surgery was necessary in 0% of the R group and 2.5% of the L group. Multivariate analysis revealed rectal cancer [p=0.003; odds ratio (OR)=2.627; 95% confidence interval (CI)=1.377-5.020] and distant metastasis (p=0.047; OR=1.731; 95%CI=1.092-3.247) as independent predictive factors for postoperative complications.
Conclusion:
Robotic surgery for bulky colorectal tumors appears to be as safe as laparoscopic surgery and may reduce the rate of conversion to open surgery.
