scholarly journals Robotic colorectal surgery: more than a fantastic toy?

2018 ◽  
Vol 3 (1) ◽  
pp. 65-68 ◽  
Author(s):  
James W.T. Toh ◽  
Kevin Phan ◽  
Seon-Hahn Kim
Keyword(s):  
Rectal Cancer ◽  
Colorectal Surgery ◽  
Da Vinci Surgical System ◽  
Current Evidence ◽  
Rectal Cancer Surgery ◽  
Cancer Trial ◽  
Robotic Colorectal Surgery ◽  
Significant Difference ◽  
Meta Analyses ◽  
Laparoscopic Assisted

AbstractThere has been a rapid rise in the number of robotic colorectal procedures worldwide since the da Vinci Surgical System robotic technology was approved for surgical procedures in the year 2000. Several recent meta-analyses and systematic reviews have shown a significant difference in outcomes between robotic and laparoscopic rectal cancer surgery. However, these results from pooled data have not been supported by the initial results reported from the Robotic assisted versus laparoscopic assisted resection for rectal cancer trial. In this article, we examine the current evidence for robotic colorectal surgery, assess its features and functionality, evaluate its learning curve and provide our perspective on its future.

scholarly journals Conventional and/or laparoscopic rectal cancer surgery: what is the current evidence?

2016 ◽  
Vol 1 (1) ◽  
pp. 13-18 ◽  
Author(s):  
Michal Mik ◽  
Lukasz Dziki ◽  
Adam Dziki
Keyword(s):  
Rectal Cancer ◽  
Minimally Invasive ◽  
Current Knowledge ◽  
Short Review ◽  
Current Evidence ◽  
Rectal Cancer Surgery ◽  
Multicenter Trials ◽  
Expert Opinions ◽  
Current State ◽  
Meta Analyses

AbstractDespite many years of experience with laparoscopic procedures in rectal cancer, the superiority of minimally invasive approaches has been questioned especially in recent years. This article is a short review of the current knowledge about laparoscopic approaches in comparison to conventional modalities in patients with rectal cancer. To present the current state of the knowledge, we focused on reports that were published in the last few years and compared them to multicenter trials and meta-analyses published last year. Our analysis mainly applied to the primary end-points of these trials. We also included expert opinions that have been published in the last several months.

scholarly journals EP.TU.1069Improved Perioperative and Survival Outcomes for Minimally Invasive Rectal Surgery

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Martin Nnaji ◽  
Kashuf Khan ◽  
Sam Hughes ◽  
Mohit Inani ◽  
Nuha A Yassin
Keyword(s):  
Rectal Cancer ◽  
Survival Data ◽  
Locoregional Recurrence ◽  
Open Surgery ◽  
Rectal Surgery ◽  
Cancer Surgery ◽  
Open Group ◽  
Current Evidence ◽  
Rectal Cancer Surgery ◽  
Significant Difference

Abstract Aim Although laparoscopic colon cancer surgery has been widely embraced as current evidence demonstrates comparable oncological results with open surgery, similar evidence is lacking for laparoscopic rectal cancer surgery. We present the outcomes of patients undergoing laparoscopic and open total mesorectal excision (TME) for rectal cancer in our unit. Methods We retrospectively analysed data collected for patients who underwent laparoscopic and open TME from January 2014 to December 2018. Sociodemographic, perioperative, circumferential resection margin (CRM) positivity, locoregional recurrence and survival data were analysed. Results 260 (144 laparoscopic and 116 open) were included. Median age in the laparoscopic group was 69 years and in the open group 68 years. Neoadjuvant therapy was given in 21 patients (14.6%) in laparoscopic and 13 (11.2%) in the open group (p = 0.42). CRM was positive in 16 cases (11.1%) laparoscopic and 32 (27.6%) open (p = 0.0007;95%CI:6.9-26.2). No statistically significant difference in anastomotic leak rate was observed both groups (4.9% laparoscopic vs 4.3% open;p=0.82). Surgical site infection was significantly more in open cases (13% vs 5.6% laparoscopic,p=0.04). Similar locoregional recurrence rates were observed in both groups (18% laparoscopic vs 19% open,p=0.84). Median follow up was 34 months or more allowed for Disease-free (DFS) and overall survival (OS) to be analysed for 144 of 260 patients. DFS and OS were better in laparoscopic (73% and 94%) compared to open (68% and 85% respectively) (p = 0.40 and p = 0.015 respectively). Conclusion From an oncological perspective, laparoscopic surgery for rectal cancer is safe with additional perioperative and survival benefits compared to open surgery.

scholarly journals The effect of rectal washout on local recurrence following rectal cancer surgery

2018 ◽  
Vol 100 (2) ◽  
pp. 146-151 ◽  
Author(s):  
SR Moosvi ◽  
K Manley ◽  
J Hernon
Keyword(s):  
Rectal Cancer ◽  
Local Recurrence ◽  
Anterior Resection ◽  
High Volume ◽  
Conclusive Evidence ◽  
Rectal Cancer Surgery ◽  
Single Institution ◽  
Recurrence Rates ◽  
Rectal Washout ◽  
Significant Difference

Introduction Local recurrence after surgery for rectal cancer is associated with significant morbidity and debilitating symptoms. Intraoperative rectal washout has been linked to a reduction in local recurrence but there is no conclusive evidence. The aim of this study was to evaluate whether performing rectal washout had any effect on the incidence of local recurrence in patients undergoing anterior resection for rectal cancer in the context of the current surgical management. Methods A total of 395 consecutive patients who underwent anterior resection with or without rectal washout for rectal cancer between January 2003 and July 2009 at a high volume single institution were analysed retrospectively. A standardised process for performing washout was used and all patients had standardised surgery in the form of total mesorectal excision. Neoadjuvant and adjuvant therapy was used on a selected basis. Patients were followed up for five years and local recurrence rates were compared in the two groups. Results Of the 395 patients, 297 had rectal washout and 98 did not. Both groups were well matched with regard to various important clinical, operative and histopathological characteristics. Overall, the local recurrence rate was 5.3%. There was no significant difference in the incidence of local recurrence between the washout group (5.7%) and the no washout group (4.1%). Conclusions Among our cohort of patients, there was no statistical difference in the incidence of local recurrence after anterior resection with or without rectal washout. This suggests that other factors are more significant in the development of local recurrence.

scholarly journals Laparoscopic Colorectal Surgery: Summary of the Current Evidence

2009 ◽  
Vol 91 (7) ◽  
pp. 541-544 ◽  
Author(s):  
Emad H Aly
Keyword(s):  
Colorectal Surgery ◽  
Enhanced Recovery ◽  
Laparoscopic Colorectal Surgery ◽  
Cost Effective ◽  
Current Evidence ◽  
Rectal Cancer Surgery ◽  
Port Site Recurrence ◽  
Medline Search ◽  
Recovery Protocols ◽  
Randomised Controlled

INTRODUCTION Laparoscopic colectomy has not been accepted as quickly as laparoscopic cholecystectomy. This is because of its steep learning curve, concerns with oncological outcomes, lack of randomised controlled trials (RCTs) and initial reports on port-site recurrence after curative resection. The aim of this review is to summarise current evidence on laparoscopic colorectal surgery. PATIENTS AND METHODS Review of literature following Medline search using key words ‘laparoscopic’, ‘colorectal’ and ‘surgery’. CONCLUSIONS Laparoscopic colorectal surgery proved to be safe, cost-effective and with improved short-term outcomes. However, further studies are needed to assess the role of laparoscopic rectal cancer surgery and the value of enhanced recovery protocols in patients undergoing laparoscopic colorectal resections.

scholarly journals Surgical outcomes of robot-assisted rectal cancer surgery using the da Vinci Surgical System: a multi-center pilot Phase II study

2017 ◽  
Vol 47 (12) ◽  
pp. 1135-1140 ◽  
Author(s):  
Shunsuke Tsukamoto ◽  
Yuji Nishizawa ◽  
Hiroki Ochiai ◽  
Yuichiro Tsukada ◽  
Takeshi Sasaki ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Da Vinci ◽  
Phase Ii Study ◽  
Da Vinci Surgical System ◽  
Rectal Cancer Surgery ◽  
Pilot Phase ◽  
Robot Assisted ◽  
System A ◽  
Vinci Surgical System ◽  
Surgical System

scholarly journals Current Evidence Does Support the Use of KT to Treat Chronic Knee Pain in Short Term: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Wen-hao Luo ◽  
Ye Li
Keyword(s):  
Knee Pain ◽  
Meta Analysis ◽  
Exercise Program ◽  
Current Evidence ◽  
Chronic Knee Pain ◽  
Randomized Controlled Studies ◽  
Significant Difference ◽  
The Mean ◽  
Meta Analyses ◽  
Better Than

Objective. To demonstrate whether KT is better than placebo taping, nonelastic taping, or no taping in reducing pain. Methods. PubMed, Embase, Web of Science, the Cochrane Central Library, and ClinicalTrials.gov were systematically searched up to 20 October 2020 for randomized controlled studies that used KT to treat chronic knee pain according to PRISMA guidelines. We extracted the mean differences and SD in pretreatment and posttreatment for selected outcomes measured in the experimental and control groups for subsequent meta-analyses. Results. In total, 8 studies involving 416 participants fulfilled the inclusion criteria. Our results indicated that KT is better than other tapings (placebo taping or nonelastic taping) in the early four weeks. The mean difference was −1.44 (95% CI: −2.04–−0.84, I2 = 49%, P ≤ 0.01 ). Treatment methods which were performed for more than six weeks (0.16 (95% CI: −0.35–0.68, I2 = 0%, P = 0.53 )) show no significant difference in reducing pain. In studies in which visual analogue scale was measured, a positive effect was observed for KT combined with exercise program training (−3.27 (95% CI: −3.69–2.85, I2 = 0%, P < 0.05 )). Conclusion. KT exhibited significant but temporary pain reduction.

scholarly journals The importance of training and education in performing total mesorectal excision in rectal cancer surgery

2017 ◽  
Vol 74 (4) ◽  
pp. 349-353
Author(s):  
Tomislav Petrovic ◽  
Ferenc Vicko ◽  
Dragana Radovanovic ◽  
Nemanja Petrovic ◽  
Milan Ranisavljevic ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Surgical Treatment ◽  
Local Recurrence ◽  
Anastomotic Leakage ◽  
New Technologies ◽  
Surgical Techniques ◽  
Cancer Surgery ◽  
Rectal Cancer Surgery ◽  
Significant Difference ◽  
Duration Of Surgery

Background/Aim. In the last two decades there has been a significant progress in rectal cancer surgery. Preoperative radiotherapy, the introduction of staplers and largely improved surgical techniques have greatly contributed to better treatment outcomes, primarily by reducing the frequency of early surgical complications and the rate of local recurrence. The aim of this study was to compare operative and postoperative results in the treatment of rectal cancer between the two groups of surgeons ? those who are closely engaged in colorectal surgery and those who deal with these issues sporadically. Methods. This retrospective study included 146 patients who had underwent rectal cancer surgery at the Institute of Oncology of Vojvodina in the period from January 1, 2008 to December 31, 2010. The patients were divided into two groups, the group N1 of 101 patients operated on by trained colorectal surgeons, and the group N2 of 45 patients operated on by surgeons without training in totalmesorectal excision (TME). Results. Preoperative chemoradiotherapy was received by 49 (33.56%) of the patients. A statistically significant difference between the two groups was noted in the duration of surgery and the need for blood transfusion during surgery. Anastomotic leakage occurred in 3 patients from the group N1 and in 10 patients from the group N2. Seven (4.79%) of the patients developed local recurrence after surgical treatment. There were significant differences in local recurrence rate and anastomotic leakage rate between the compared groups. Conclusion. It is necessary to continue education and training in surgery for rectal cancer to master new technologies and surgical techniques and to improve the results of surgical treatment.

The Use of Enhanced Technologies in Robotic Surgery and Its Impact on Outcomes in Rectal Cancer: A Systematic Review

2020 ◽  
pp. 155335062092827
Author(s):  
Patricia Tejedor ◽  
Filippos Sagias ◽  
Jim S. Khan
Keyword(s):  
Rectal Cancer ◽  
Colorectal Surgery ◽  
Rectal Surgery ◽  
Postoperative Outcomes ◽  
Fluorescence Angiography ◽  
Rectal Disease ◽  
Short Term ◽  
Robotic Colorectal Surgery ◽  
Technological Advantage ◽  
Table Motion

The main advantage of the robotic approach is the surgical precision that the technology offers. It is particularly useful in rectal cancer as this is a technically challenging procedure. The technological advantage of the robot leads to better postoperative outcomes. Apart from the 3D vision and endowrist instrumentation in comparison to laparoscopy, the options of using fluorescence imaging, endowrist stapler, and table motion have revolutionised the way of performing an anterior resection. Thus, the true benefit of these advances will be the quality of the surgery, which leads to better postoperative outcomes. This article focuses on the current status of applications of new modalities and technology development in robotic rectal surgery. A systematic literature search was performed using PubMed, MEDLINE, and cochrane database. The studies included were considered based on the following (1) articles written in English, (2) full text is available, (3) whether the topic is related to the use of novel technologies during robotic rectal surgery, and (4) sample: adult patients and malignant rectal disease. The primary end point was to analyse the current use of technological advances in robotic rectal surgery. Only a few studies are currently available on the use of these different technologies in robotic colorectal surgery. Many of these reports describe promising results, although with short-term outcomes. The use of technologies in robotic colorectal surgery is safe and feasible and can be used together to improve short-term outcomes. Intraoperative fluorescence angiography has demonstrated to reduce the rate of anastomotic leak, whereas the robotic stapler and the table motion simplify anatomic resection.

scholarly journals Case Report: Early Recognition and Repair of Distal Iatrogenic Ureteral Injury During Laparoscopic Rectal Surgery

2021 ◽  
Vol 2 (2) ◽  
pp. 73-76
Author(s):  
Abdul Mughni ◽  
Ahmad Fathi Fuadi ◽  
Nanda Daniswara
Keyword(s):  
Rectal Cancer ◽  
Colorectal Surgery ◽  
Early Recognition ◽  
Rectal Surgery ◽  
Laparoscopic Approach ◽  
Ureteral Injury ◽  
Uneventful Recovery ◽  
Rectal Cancer Surgery ◽  
Distal Ureter ◽  
Iatrogenic Ureteral Injury

Background: Ureteral injury is an uncommon complication of the colorectal procedure. The colorectal procedure is the second most common cause of ureteral injury. The laparoscopic approach for colorectal surgery has contributed to the increase of ureteral injury. Delayed diagnosis of the iatrogenic ureteral injury is associated with higher morbidity. However, the early diagnosis of ureteral injury during the operation is difficult. We presented an early recognition and laparoscopic repair of iatrogenic ureteral injury during laparoscopic rectal cancer surgery cases and the strategy for recognizing and managing that injury for the surgeon.Case Presentation: A Male, 34 years old, had an iatrogenic ureteral injury during laparoscopic low anterior resection for rectal cancer. The left distal ureter was transected by an energy device. The diagnosis of ureteral injury was prompt. The repair of the ureter was done endo-laparoscopically. The patient had an uneventful recovery and was discharged on day 6 after surgery.Conclusion: The iatrogenic ureteral injury, although uncommon, is a serious complication of laparoscopic colorectal surgery. Direct visual identification of the distal ureter is mandatory in every rectal surgery. The iatrogenic ureteral injury is not an indication for open conversion when there is an adequate resource to do the endo-laparoscopic ureteral repair.

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