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Updated: May 28, 2026
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Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
Oncologic Outcomes of Robot-Assisted Upfront Surgery Using a Fascia-Guided Total Mesorectal Excision Strategy for T3
Shota Izukawa1, Masakatsu Numata1, Keisuke Kazama2
1Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, 4-57, Urafune-cho, Minami-ku, Yokohama-city, Kanagawa, 232-0024, Japan.
Diseases of the Colon and Rectum
|May 27, 2026
Summary
Robot-assisted surgery for rectal cancer shows promising results. This study found low local recurrence rates and good survival in patients with T3 rectal cancer undergoing upfront robotic surgery with fascia-guided total mesorectal excision.
Area of Science:
- Colorectal Surgery
- Surgical Oncology
- Robotic Surgery
Background:
- Local recurrence is a significant challenge in rectal cancer treatment.
- Total mesorectal excision (TME) is standard, but achieving optimal local control remains difficult.
- Robotic technology and improved understanding of fascial planes enable high-quality, fascia-guided TME.
Purpose of the Study:
- To evaluate oncologic outcomes of robot-assisted upfront surgery.
- To assess outcomes using a fascia-guided TME framework.
- To analyze results in a homogeneous cohort of pathological T3 rectal cancer patients.
Main Methods:
- Retrospective cohort study at two high-volume centers.
- Included 125 patients with pathological T3 rectal adenocarcinoma undergoing robot-assisted primary resection (June 2017-August 2023).
- Primary endpoint: 3-year cumulative incidence of local recurrence; secondary endpoints: overall survival and relapse-free survival.
Main Results:
- Median follow-up was 43.4 months.
- 3-year cumulative local recurrence incidence was 2.04% (Stage II: 1.80%; Stage III: 2.36%).
- 3-year overall survival: 93.9%; 3-year relapse-free survival: 72.8%.
Conclusions:
- Robot-assisted upfront surgery with fascia-guided TME achieved low local recurrence in pathological T3 rectal cancer.
- Favorable survival outcomes were observed in this cohort.
- Provides benchmark data for evaluating upfront surgical strategies in rectal cancer.
