Robotic Total Mesorectal Excision for Rectal Cancer: Short-Term Oncological Outcomes of Initial 178 Cases.
Da Vinci surgical system
Rectal cancer
Robotic rectal resection
Robotic total mesorectal excision
Journal
Indian journal of surgical oncology
ISSN: 0975-7651
Titre abrégé: Indian J Surg Oncol
Pays: India
ID NLM: 101532448
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
received:
20
05
2020
accepted:
03
09
2020
entrez:
7
12
2020
pubmed:
8
12
2020
medline:
8
12
2020
Statut:
ppublish
Résumé
Emerging techniques in minimally invasive rectal resection include robotic total mesorectal excision (R-TME). The Da Vinci Surgical System offers precise dissection in narrow and deep confined spaces and is gaining increasing acceptance during recent times. The aim of this study is to analyse our initial experience of R-TME with Da Vinci Xi platform in terms of perioperative and oncological outcomes in the context of data from recently published randomised ROLARR trial amongst minimally invasive novice surgeons. Patients who underwent R-TME or tumour specific mesorectal excision for rectal cancer between May 2016 and November 2019 were identified from a prospectively maintained single institution colorectal database. Demographic, clinical-pathological and short-term oncological outcomes were analysed. Of the 178 patients, 117 (65.7%) and 31 (17.4%) patients had lower and mid third rectal cancer. Most of the tumours were locally advanced, cT3-T4: 138 (77.5%). One hundred/178 (56.2%) underwent sphincter preserving TME. Eighty-seven (48.8%) were grade II adenocarcinoma. Nonmucinous adenocarcinoma was the predominant histology, 138 (78.4%). One hundred one cases (56.7%) were pT3. The mean number of lymph node yield was 13 ± 5. Distal resection margin and circumferential resection margin were positive in 2 (1.12%), 12 cases (6.74%) respectively. Eleven cases (6.7%) had to be converted to open TME. Mean blood loss and duration of surgery was 170 ± 60 ml and 286 ± 45 min respectively. Five percent cases had an anastomotic leak. Grade IIIa-IIIb Clavien Dindo (CD) morbidity score was reported to be in 12 (6.75%) and 10 (5.61%) cases. Median length of hospitalisation was 7 days (range 4-14 days). Perioperative and pathologic outcomes following robotic rectal resection is associated with good short-term oncological outcomes and is safe, effective, and reproducible by a minimally invasive novice surgeon.
Identifiants
pubmed: 33281405
doi: 10.1007/s13193-020-01212-5
pii: 1212
pmc: PMC7714805
doi:
Types de publication
Journal Article
Langues
eng
Pagination
653-661Informations de copyright
© The Author(s) 2020.
Déclaration de conflit d'intérêts
Conflict of InterestThe authors declare that they have no conflict of interest.
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