Robot-assisted rectal cancer surgery: short-term outcomes for 113 consecutive patients

Abstract

Purpose: The purpose of this study was to assess the short-term outcome of robot-assisted laparoscopic surgery (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 2013, 113 consecutive patients underwent RALS for rectal cancer. Surgical outcomes, pathological results, and postoperative complications were prospectively collected.

Results: There were 78 males and 35 females; 30 patients (26.5%) had cT1 tumor, 14 (12.4%) had cT2, 56 (49.6%) had cT3, and 12 (10.6%) had cT4 tumor. The types of procedures performed were 82 anterior resections, 23 intersphincteric resections, and 8 abdominoperineal resections. RALLD was performed in 38 patients (33.6%). The overall median operative time was 302 (135-683) min. In cases without RALLD, the median operative time was 242 (135-529) min, while median operative time was 486 (320-683) 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 2.7%. Ten patients who developed urinary retention recovered completely within 30 days after the operation.

Conclusions: RALS for rectal cancer is a technically feasible, less invasive procedure. This procedure can be performed with low morbidity and a low conversion rate, even for cases with advanced rectal cancer requiring complicated, robot-assisted, lateral lymph node dissection.