Total mesorectal excision: a comparison of oncological and functional outcomes between robotic and laparoscopic surgery for rectal cancer

2013 ◽  
Vol 27 (6) ◽  
pp. 1887-1895 ◽  
Author(s):  
Annibale D’Annibale ◽  
Graziano Pernazza ◽  
Igor Monsellato ◽  
Vito Pende ◽  
Giorgio Lucandri ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Total Mesorectal Excision ◽  
Functional Outcomes ◽  
Mesorectal Excision

scholarly journals Rise and fall of total mesorectal excision with lateral pelvic lymphadenectomy for rectal cancer: an updated systematic review and meta-analysis of 11,366 patients

2021 ◽  
Author(s):  
Gabriele Anania ◽  
Richard Justin Davies ◽  
Alberto Arezzo ◽  
Francesco Bagolini ◽  
Vito D’Andrea ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Neoadjuvant Therapy ◽  
Functional Outcomes ◽  
Meta Analysis ◽  
Neoadjuvant Chemoradiotherapy ◽  
Disease Free Survival ◽  
Mesorectal Excision ◽  
Timeline Analysis

Abstract The role of lateral lymph node dissection (LLND) during total mesorectal excision (TME) for rectal cancer is still controversial. Many reviews were published on prophylactic LLND in rectal cancer surgery, some biased by heterogeneity of overall associated treatments. The aim of this systematic review and meta-analysis is to perform a timeline analysis of different treatments associated to prophylactic LLND vs no-LLND during TME for rectal cancer. Methods A literature search was performed in PubMed, SCOPUS and WOS for publications up to 1 September 2020. We considered RCTs and CCTs comparing oncologic and functional outcomes of TME with or without LLND in patients with rectal cancer. Results Thirty-four included articles and 29 studies enrolled 11,606 patients. No difference in 5-year local recurrence (in every subgroup analysis including preoperative neoadjuvant chemoradiotherapy), 5-year distant and overall recurrence, 5-year overall survival and 5-year disease-free survival was found between LLND group and non LLND group. The analysis of post-operative functional outcomes reported hindered quality of life (urinary, evacuatory and sexual dysfunction) in LLND patients when compared to non LLND. Conclusion Our publication does not demonstrate that TME with LLND has any oncological advantage when compared to TME alone, showing that with the advent of neoadjuvant therapy, the advantage of LLND is lost. In this review, the most important bias is the heterogeneous characteristics of patients, cancer staging, different neoadjuvant therapy, different radiotherapy techniques and fractionation used in different studies. Higher rate of functional post-operative complications does not support routinely use of LLND.

scholarly journals Single-Access Laparoscopic Rectal Surgery Is Technically Feasible

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Siripong Sirikurnpiboon ◽  
Paiboon Jivapaisarnpong
Keyword(s):  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Total Mesorectal Excision ◽  
Perioperative Complications ◽  
Rectal Surgery ◽  
Anal Canal Cancer ◽  
Mesorectal Excision ◽  
Single Access ◽  
Laparoscopic Rectal Surgery ◽  
The Mean

Introduction. Single-access laparoscopic surgery (SALS) has been successfully introduced for colectomy surgery; however, for mid to low rectum procedures such as total mesorectal excision, it can be technically complicated. In this study, we introduced a single-access technique for rectum cancer operations without the use of other instruments.Aims. To show the short-term results of single-access laparoscopic rectal surgery in terms of pathologic results and immediate complications.Settings and Design. Prospective study.Materials and Methods. We selected middle rectum to anal canal cancer patients to undergo single-access laparoscopic rectal resection for rectal cancer. All patients had total mesorectal excisions. An umbilical incision was made for the insertion of a single multichannel port, and a mesocolic window was created to identify the inferior mesenteric artery and vein. Total mesorectal excision was performed. There were no perioperative complications. The mean operative time was 269 minutes; the median hospital stay was 7 days; the mean wound size was 5.5 cm; the median number of harvested lymph nodes was 15; and all patients had intact mesorectal capsules.Statistical Analysis Used. Mean, minimum–maximum.Conclusion. Single-access laparoscopic surgery for rectal cancer is feasible while oncologic principles and patient safety are maintained.

scholarly journals Comparison of short-term outcomes between Chinese surgical robot “Micro Hand S” assisted and laparoscopic total mesorectal excision for rectal cancer

2020 ◽  
Author(s):  
Yanlei Wang ◽  
Guohui Wang ◽  
Zheng Li ◽  
Ling Hao ◽  
Bo Yi ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Functional Outcomes ◽  
Length Of Hospital Stay ◽  
Surgical Robot ◽  
Postoperative Outcomes ◽  
Large Sample Size ◽  
Mesorectal Excision ◽  
Robot Assisted ◽  
Significant Difference

Abstract Background As the first domestically produced Chinese surgical robot for clinical use, the Micro Hand S robot has been applied to total mesorectal excision (TME) for rectal cancer in our center since 2017. The aim of this study was to evaluate the safety and feasibility of the Micro Hand S robot-assisted TME (R-TME) in comparison with laparoscopic TME (L-TME).Methods Between May 2017 and February 2018, patients who underwent R-TME and L-TME in the Third Xiangya Hospital were prospectively included in this study. The data including intraoperative outcomes, postoperative outcomes, pathological outcomes, and functional outcomes were analyzed and compared.Results Totally, 30 patients underwent L-TME and 21 patients underwent R-TME. The patient characteristics of the two groups were similar. Regarding intraoperative and postoperative outcomes, the R-TME group had significantly less blood loss (95.2 vs. 130.0 ml, p = 0.022), shorter time to first flatus (2.1 vs. 2.9 d, p = 0.017) and first liquid intake (2.8 vs. 3.7 d, p = 0.027) than the L-TME group. There were no significant difference in the operative time, conversion, protective ileostomy, length of hospital stay, pain score, complications, and 30-day mortality between the two groups (p > 0.05). In addition, the pathological and functional outcomes also did not differ significantly.Conclusion The Micro Hand S robot-assisted total mesorectal excision is safe and feasible for rectal cancer. However, prospective and large sample size trials are needed to further confirm this conclusion.Trial registration:Clinicaltrial.gov, NCT02752698, Registered on 27 April 2016, https://clinicaltrials.gov/ct2/show/study/NCT02752698?term=Micro+hand&cntry=CN&draw=2&rank=1

Functional Outcomes and Quality of Life After Transanal Total Mesorectal Excision For Rectal Cancer

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
F. Borja de Lacy ◽  
Víctor Turrado ◽  
Alba Torroella ◽  
Jacqueline van Laarhoven ◽  
Ana Otero-Piñeiro ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Functional Outcomes ◽  
Transanal Total Mesorectal Excision ◽  
Mesorectal Excision
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