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Robotic-Laparoscopic Rectal Cancer Excision Versus Traditional Laparoscopy

BACKGROUND AND OBJECTIVES: Robotic surgery has been advocated for the radical excision of rectal cancer. Most data supporting its use have been reported from European and Asian centers, with a paucity of data from the United States documenting clear advantages of the robotic technique. This study co...

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Autores principales: Tam, Michael S., Abbass, Mohammad, Abbas, Maher A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Society of Laparoendoscopic Surgeons 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4208889/
https://www.ncbi.nlm.nih.gov/pubmed/25392653
http://dx.doi.org/10.4293/JSLS.2014.00020
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author Tam, Michael S.
Abbass, Mohammad
Abbas, Maher A.
author_facet Tam, Michael S.
Abbass, Mohammad
Abbas, Maher A.
author_sort Tam, Michael S.
collection PubMed
description BACKGROUND AND OBJECTIVES: Robotic surgery has been advocated for the radical excision of rectal cancer. Most data supporting its use have been reported from European and Asian centers, with a paucity of data from the United States documenting clear advantages of the robotic technique. This study compares the short-term outcome of robotic versus laparoscopic surgery. METHODS: Consecutive patients who underwent laparoscopic (group 1) or robotic (group 2) rectal cancer excision at a single institution over a 2-year period were retrospectively reviewed. The main outcome measures were operative time, blood loss, conversion rates, number of lymph nodes, margin positivity, length of hospital stay, complications, and readmission rates. RESULTS: Forty-two patients were analyzed. The median operative time was shorter in group 1 than that in group 2 (240 minutes vs 260 minutes, P = .04). No difference was noted in blood loss, transfusion rates, intraoperative complications, or conversion rates. There was no difference in circumferential or distal margin positivity. The median length of stay was shorter in group 1 (5 days vs 6 days, P = .05). The 90-day complication rate was similar in both groups (33% vs 43%, P = .75), but there was a trend toward more anastomotic leaks in group 1 (14% vs 0%, P = .23). Similarly, a non–statistically significant trend toward a higher readmission rate was noted in group 1 (24% vs 5%, P = .18). CONCLUSION: Robotic rectal cancer excision yielded a longer operative time and hospital length of stay, although immediate oncologic results were comparable. The need for randomized data is critical to determine whether the added resource utilization in robotic surgery is justifiable.
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spelling pubmed-42088892014-10-27 Robotic-Laparoscopic Rectal Cancer Excision Versus Traditional Laparoscopy Tam, Michael S. Abbass, Mohammad Abbas, Maher A. JSLS Scientific Papers BACKGROUND AND OBJECTIVES: Robotic surgery has been advocated for the radical excision of rectal cancer. Most data supporting its use have been reported from European and Asian centers, with a paucity of data from the United States documenting clear advantages of the robotic technique. This study compares the short-term outcome of robotic versus laparoscopic surgery. METHODS: Consecutive patients who underwent laparoscopic (group 1) or robotic (group 2) rectal cancer excision at a single institution over a 2-year period were retrospectively reviewed. The main outcome measures were operative time, blood loss, conversion rates, number of lymph nodes, margin positivity, length of hospital stay, complications, and readmission rates. RESULTS: Forty-two patients were analyzed. The median operative time was shorter in group 1 than that in group 2 (240 minutes vs 260 minutes, P = .04). No difference was noted in blood loss, transfusion rates, intraoperative complications, or conversion rates. There was no difference in circumferential or distal margin positivity. The median length of stay was shorter in group 1 (5 days vs 6 days, P = .05). The 90-day complication rate was similar in both groups (33% vs 43%, P = .75), but there was a trend toward more anastomotic leaks in group 1 (14% vs 0%, P = .23). Similarly, a non–statistically significant trend toward a higher readmission rate was noted in group 1 (24% vs 5%, P = .18). CONCLUSION: Robotic rectal cancer excision yielded a longer operative time and hospital length of stay, although immediate oncologic results were comparable. The need for randomized data is critical to determine whether the added resource utilization in robotic surgery is justifiable. Society of Laparoendoscopic Surgeons 2014 /pmc/articles/PMC4208889/ /pubmed/25392653 http://dx.doi.org/10.4293/JSLS.2014.00020 Text en © 2014 by JSLS, Journal of the Society of Laparoendoscopic Surgeons. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/us/), which permits for noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is not altered in any way.
spellingShingle Scientific Papers
Tam, Michael S.
Abbass, Mohammad
Abbas, Maher A.
Robotic-Laparoscopic Rectal Cancer Excision Versus Traditional Laparoscopy
title Robotic-Laparoscopic Rectal Cancer Excision Versus Traditional Laparoscopy
title_full Robotic-Laparoscopic Rectal Cancer Excision Versus Traditional Laparoscopy
title_fullStr Robotic-Laparoscopic Rectal Cancer Excision Versus Traditional Laparoscopy
title_full_unstemmed Robotic-Laparoscopic Rectal Cancer Excision Versus Traditional Laparoscopy
title_short Robotic-Laparoscopic Rectal Cancer Excision Versus Traditional Laparoscopy
title_sort robotic-laparoscopic rectal cancer excision versus traditional laparoscopy
topic Scientific Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4208889/
https://www.ncbi.nlm.nih.gov/pubmed/25392653
http://dx.doi.org/10.4293/JSLS.2014.00020
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