scholarly journals Robotic Versus Laparoscopic Surgery for Rectal Cancer: A Comprehensive Review of Oncological Outcomes

2021 ◽  
Vol 25 (4) ◽  
Author(s):  
Jessica Lam
Keyword(s):  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Comprehensive Review ◽  
Oncological Outcomes

Robotic surgery for rectal cancer: Short-term and oncological outcomes for 607 consecutive patients.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 756-756
Author(s):  
Akio Shiomi ◽  
Tomohiro Yamaguchi ◽  
Hiroyasu Kagawa ◽  
Yushi Yamakawa ◽  
Akinobu Furutani ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Operative Time ◽  
Autonomic Nerve ◽  
Relapse Free Survival ◽  
Short Term ◽  
Free Survival ◽  
Oncological Outcomes ◽  
Oncological Results ◽  
Median Operative Time

756 Background: Conventional laparoscopic surgery (CLS) for rectal cancer has several inherent technical difficulties, including a limited range of motion of the instruments.Robot-assisted laparoscopic surgery (RALS) has some technical advantages over CLS because it improves dexterity with an increased range of movements at the tips of the instruments. The purpose of this study was to evaluate the short-term and oncological outcomes of RALS for rectal cancer, including robotic, autonomic nerve-preserving, lateral lymph node dissection (RALLD), a new, technically challenging procedure. Methods: Between December 2011 and August 2017, 607 consecutive patients underwent RALS for rectal cancer. Surgical outcomes, pathological results, and oncological results were investigated retrospectively. Results: There were 403 males and 204 females; 577 patients had adenocarcinoma, 19 had carcinoid tumor, 8 had GIST, and 2 had other malignant tumor. The types of procedures performed were: 453 anterior resections, 93 intersphincteric resections, and 61 abdominoperineal resections. RALLD was performed in 202 patients (33.3%). Preoperative chemoradiotherapy was performed in 34 patients. The overall median operative time was 257(109-683) min. In cases without RALLD, the median operative time was 217 (109-545) min, while median operative time was 420 (162-683) min with RALLD. None of the cases was converted to an open or laparoscopic procedure.There was no surgical mortality. The overall complication rate for Clavien-Dindo classification grade III-IV was 3.0%. The oncological results for 279 patients with primary rectal adenocarcinoma, operated before December 2014 was also investigated (Stage I/II/III 115/48/116). The 5-year overall survival was 96.6%, the 3-year relapse free survival was 88.3%, and 3-year local relapse free survival was 98.5%. The 3-year RFS of pStage I/II/III was 96.2/89.6/79.6% respectively. Conclusions: RALS for rectal cancer is a feasible procedure with low morbidity and a low conversion rate, and acceptable oncological results.

scholarly journals Influence of Tumor Location on Short- and Long-Term Outcomes After Laparoscopic Surgery for Rectal Cancer: A Propensity Score Matched Cohort Study

2020 ◽  
Author(s):  
Hong Yang ◽  
Zhendan Yao ◽  
Ming Cui ◽  
Jiadi Xing ◽  
Chenghai Zhang ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Multivariate Analysis ◽  
Laparoscopic Surgery ◽  
Laparoscopic Resection ◽  
Independent Predictor ◽  
Tumor Location ◽  
Long Term Outcomes ◽  
Oncological Outcomes ◽  
Short And Long Term

Abstract Background: This study aimed to evaluate the short- and long-term outcomes after laparoscopic resection for low rectal cancer (LRC) compared with mid/high rectal cancer (M/HRC). Methods: Patients with rectal cancer undergoing laparoscopic resection with curative intent were retrospectively reviewed between 2009 and 2015. After matched 1:1 by using propensity score analysis, perioperative and oncological outcomes were compared between LRC and M/HRC groups. Multivariate analysis was performed to identify independent factors of overall survival (OS) and disease-free survival (DFS). Results: Of 373 patients who met the criteria for inclusion, 260 patients were matched for the analysis. Laparoscopic surgery for LRC required longer operative time (P＜0.001) and more blood loss volume (P＜0.001) compared with M/HRC, and the LRC group tended to have a higher incidence of postoperative complications (18.5% vs. 10.0%, P=0.051). There was no significant difference in local recurrence between the two groups (6.2% vs. 2.3%, P=0.216), whereas distant metastasis was more frequent in LRC patients compared with M/HRC (19.2% vs. 9.2%, P=0.021). The LRC group showed significantly inferior 5-year OS (78.1% vs. 88.8%, P=0.008) and DFS (76.2% vs. 89.0%, P=0.004) compared with the M/HRC group. Multivariate analysis indicated that tumor location was an independent predictor of OS (HR=2.095, 95% CI 1.142-3.843, P=0.017) and DFS (HR=2.320, 95% CI 1.251-4.303, P=0.008). Conclusion: Tumor location of the rectal cancer significantly affected the clinical and oncological outcomes after laparoscopic surgery, and it was an independent predictor of OS and DFS.

scholarly journals Influence of Tumor Location on Short- and Long-Term Outcomes After Laparoscopic Surgery for Rectal Cancer: A Propensity Score Matched Cohort Study

2020 ◽  
Author(s):  
Hong Yang ◽  
Zhendan Yao ◽  
Ming Cui ◽  
Jiadi Xing ◽  
Chenghai Zhang ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Multivariate Analysis ◽  
Laparoscopic Surgery ◽  
Laparoscopic Resection ◽  
Independent Predictor ◽  
Tumor Location ◽  
Long Term Outcomes ◽  
Oncological Outcomes ◽  
Short And Long Term

Abstract Background: This study aimed to evaluate the short- and long-term outcomes after laparoscopic resection for low rectal cancer (LRC) compared with mid/high rectal cancer (M/HRC). Methods: Patients with rectal cancer undergoing laparoscopic resection with curative intent were retrospectively reviewed between 2009 and 2015. After matched 1:1 by using propensity score analysis, perioperative and oncological outcomes were compared between LRC and M/HRC groups. Multivariate analysis was performed to identify independent factors of overall survival (OS) and disease-free survival (DFS). Results: Of 373 patients who met the criteria for inclusion, 198 patients were matched for the analysis. Laparoscopic surgery for LRC required longer operative time (P＜0.001) and more blood loss volume (P=0.015) compared with M/HRC, and the LRC group tended to have a higher incidence of postoperative complications (16.2% vs. 8.1%, P=0.082). There was no significant difference in local recurrence between the two groups (9.1% vs. 4.0%, P=0.251), whereas distant metastasis was inclined to be more frequent in LRC patients compared with M/HRC (21.2% vs. 12.1%, P=0.086). The LRC group showed significantly inferior 5-year OS (77.0% vs. 86.4%, P=0.033) and DFS (71.2% vs. 86.2%, P=0.017) compared with the M/HRC group. Multivariate analysis indicated that tumor location was an independent predictor of DFS (HR=2.305, 95% CI 1.203-4.417, P=0.012). Conclusion: Tumor location of the rectal cancer significantly affected the clinical and oncological outcomes after laparoscopic surgery, and it was an independent predictor of DFS.

Prognosis Comparisons of Laparoscopy versus Open Surgery for Rectal Cancer Patients after Preoperative Chemoradiotherapy: A Meta-Analysis

2021 ◽  
Vol 44 (5) ◽  
pp. 261-268
Author(s):  
Jin-Wei Niu ◽  
Wu Ning ◽  
Zhi-Ze Liu ◽  
Dong-Po Pei ◽  
Fan-Qiang Meng ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Postoperative Complications ◽  
Open Surgery ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Current Evidence ◽  
Open Thoracotomy ◽  
Oncological Outcomes ◽  
Duration Of Surgery

<b><i>Aim:</i></b> We aimed to compare the oncological outcomes of laparoscopy and open resection for patients with rectal cancer following neoadjuvant chemoradiotherapy (NCRT). <b><i>Methods:</i></b> We searched the publications that compared the efficacy of laparoscopic surgery and open thoracotomy in treatment outcomes of rectal cancer after NCRT. All trials analyzed the summary hazard ratios of the endpoints of interest, including survival and individual postoperative complications. <b><i>Results:</i></b> Totally, 10 trials met our inclusion criteria. The pooled analysis of 3-year disease-free survival (OR 1.39, 95% CI 0.93–2.06; <i>p</i> = 0.11) and 3-year overall survival (OR 1.01, 95% CI 0.70–1.45; <i>p</i> = 0.97) showed that laparoscopic surgery did not achieve beneficial effects compared with open thoracotomy. The pooled result of duration of surgery indicated that laparoscopic surgery was associated with a trend for longer surgery time (SMD 27.53, 95% CI 1.34–53.72; <i>p</i> = 0.04), shorter hospital stay (SMD –1.64, 95% CI –2.70 to –0.58; <i>p</i> = 0.002), more postoperative complications (OR 0.77, 95% CI 0.60–0.99; <i>p</i> = 0.04), and decreased blood loss (SMD –49.87, 95% CI –80.61 to –19.14; <i>p</i> = 0.001). However, the number of removed lymph nodes, positive circumferential resection margin, as well as complications after surgery showed significant differences between the 2 groups. <b><i>Conclusions:</i></b> We focused on current evidence and reviewed the studies indicating that similar oncological outcomes were associated with laparoscopic surgery following NCRT for patients with locally advanced lower rectal cancer in comparison with open surgery.

scholarly journals Conversion-to-open of laparoscopic surgery for rectal cancer: Impact on outcomes

2014 ◽  
Vol 61 (2) ◽  
pp. 31-33
Author(s):  
Evaghelos Xynos
Keyword(s):  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Low Anterior Resection ◽  
Survival Rates ◽  
Mortality Rates ◽  
Wound Infection Rate ◽  
Mesorectal Excision ◽  
Technical Limitation ◽  
Oncological Outcomes ◽  
Duration Of Surgery

Low anterior resection of the rectum (LARR) with total mesorectal excision (TME) for rectal cancer by laparoscopy is considered very technically demanding, particularly at the stages of dissection around the mesorectal fascia deep into the pelvis and transection of the rectum distally to the tumour. These technical difficulties translate to an increased conversion-to-open rate, higher than that seen after laparoscopic surgery for colon cancer. Conversion-to-open is considered as a technical limitation of the approach rather than a complication. There are reports claiming that converted cases are associated with higher morbidity rates than the laparoscopically completed. However, a review of the published articles indicates that conversion-to-open shows similar overall morbidity and mortality rates to those seen in the laparoscopically completed LARR-TME cases, and only duration of surgery is longer and wound infection rate is higher in the former group. Similarly, the overall oncological outcomes, namely local recurrence, distant metastasis and overall survival rates, are similar between the two groups.

scholarly journals Influence of Tumor Location on Short- and Long-Term Outcomes After Laparoscopic Surgery for Rectal Cancer: A Propensity Score Matched Cohort Study

2020 ◽  
Author(s):  
Hong Yang ◽  
Zhendan Yao ◽  
Ming Cui ◽  
Jiadi Xing ◽  
Chenghai Zhang ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Multivariate Analysis ◽  
Laparoscopic Surgery ◽  
Laparoscopic Resection ◽  
Independent Predictor ◽  
Tumor Location ◽  
Long Term Outcomes ◽  
Oncological Outcomes ◽  
Short And Long Term

Abstract Background: This study aimed to evaluate the short- and long-term outcomes after laparoscopic resection for low rectal cancer (LRC) compared with mid/high rectal cancer (M/HRC). Methods: Patients with rectal cancer undergoing laparoscopic resection with curative intent were retrospectively reviewed between 2009 and 2015. After matched 1:1 by using propensity score analysis, perioperative and oncological outcomes were compared between LRC and M/HRC groups. Multivariate analysis was performed to identify independent factors of overall survival (OS) and disease-free survival (DFS). Results: Of 373 patients who met the criteria for inclusion, 260 patients were matched for the analysis. Laparoscopic surgery for LRC required longer operative time (P＜0.001) and more blood loss volume (P＜0.001) compared with M/HRC, and the LRC group tended to have a higher incidence of postoperative complications (18.5% vs. 10.0%, P=0.051). There was no significant difference in local recurrence between the two groups (6.2% vs. 2.3%, P=0.216), whereas distant metastasis was more frequent in LRC patients compared with M/HRC (19.2% vs. 9.2%, P=0.021). The LRC group showed significantly inferior 5-year OS (78.1% vs. 88.8%, P=0.008) and DFS (76.2% vs. 89.0%, P=0.004) compared with the M/HRC group. Multivariate analysis indicated that tumor location was an independent predictor of OS (HR=2.095, 95% CI 1.142-3.843, P=0.017) and DFS (HR=2.320, 95% CI 1.251-4.303, P=0.008). Conclusion: Tumor location of the rectal cancer significantly affected the clinical and oncological outcomes after laparoscopic surgery, and it was an independent predictor of OS and DFS.

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