Robotic-assisted surgery versus open surgery in the treatment of rectal cancer: the current evidence.
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ABSTRACT:
SUBMITTER: Liao G
PROVIDER: S-EPMC4882598 | biostudies-literature | 2016 May
REPOSITORIES: biostudies-literature
Publications
Robotic-assisted surgery versus open surgery in the treatment of rectal cancer: the current evidence.
Liao Guixiang G Li Yan-Bing YB Zhao Zhihong Z Li Xianming X Deng Haijun H Li Gang G
Scientific reports 20160527
The aim of this meta-analysis was to comprehensively compare the safety and efficacy of robotic-assisted rectal cancer surgery (RRCS) and open rectal cancer surgery (ORCS). Electronic database (PubMed, EMBASE, Web of Knowledge, and the Cochrane Library) searches were conducted for all relevant studies that compared the short-term and long-term outcomes between RRCS and ORCS. Odds ratios (ORs), mean differences, and hazard ratios were calculated. Seven studies involving 1074 patients with rectal ...[more]
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Project description:To give a comprehensive review of current literature on robotic rectal cancer surgery.A systematic review of current literature via PubMed and Embase search engines was performed to identify relevant articles from january 2007 to november 2013. The keywords used were: "robotic surgery", "surgical robotics", "laparoscopic computer-assisted surgery", "colectomy" and "rectal resection".After the initial screen of 380 articles, 20 papers were selected for review. A total of 1062 patients (male 64.0%) with a mean age of 61.1 years and body mass index of 24.9 kg/m(2) were included in the review. Out of 1062 robotic-assisted operations, 831 (78.2%) anterior and low anterior resections, 132 (12.4%) intersphincteric resection with coloanal anastomosis, 98 (9.3%) abdominoperineal resections and 1 (0.1%) Hartmann's operation were included in the review. Robotic rectal surgery was associated with longer operative time but with comparable oncological results and anastomotic leak rate when compared with laparoscopic rectal surgery.Robotic colorectal surgery has continued to evolve to its current state with promising results; feasible surgical option with low conversion rate and comparable short-term oncological results. The challenges faced with robotic surgery are for more high quality studies to justify its cost.
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Project description:ObjectiveThis study aimed to compare the short-term and long-term outcomes between robotic-assisted simultaneous resection and open surgery in patients with rectal cancer and liver metastases.BackgroundOpen simultaneous resection of colorectal cancer and synchronous liver metastases is widely performed and the potential cure for eligible patients. However, the feasibility of robotic simultaneous resection of primary and secondary liver lesions has not been established as a treatment option for metastatic rectal cancer.Patients and methodsA single-center randomized controlled trial was conducted at a hospital in China. Enrolling patients were aged from 18 to 75 years and diagnosed with surgically resectable metastatic rectal cancer (distal extension to ≤15 cm from the anal margin). Patients selected for simultaneous resection were randomly assigned to have robotic or open surgery at a 1:1 ratio. The primary endpoint was the incidence rate of complications within 30 days after surgery. Secondary endpoints were bladder, sexual function, 3-year disease-free survival and overall survival.ResultsA total of 171 patients were enrolled in this trial with 86 in the robotic group and 85 in the open group. As a result, patients in the robotic group demonstrated fewer complications within 30 days after surgery than those in the open group (31.4% vs. 57.6%, P=0.014) and no mortality seen in either group. Patients in the robotic group had less blood loss (mean [SD], 125.5 [38.3] vs. 211.6 [68.7] mL; P<0·001), faster bowel function recovery (mean [SD], 63.7 [27.4] vs. 93.8 [33.5] hours) P<0·001) and shorter hospital stay (mean [SD], 8.0 [2.2] vs. 10.7 [5.4] days; P<0·001) compared with those in the open group. The robotic group had faster recovery of bladder and sexual function at 3 months after surgery than that of the open group. The 3-year disease-free survival rate (39.5% vs. 35.3%, P=0.739) and the 3-year overall survival rate (76.7% vs. 72.9%, P=0.712) were not statistically significant between the two groups.ConclusionsIn our randomized clinical trial, robotic simultaneous resection treatment of patients with rectal cancer and liver metastases resulted in fewer surgical complications, and faster recovery to those of open surgery. Oncological outcomes showed no significant difference between two groups.
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