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. 2021 Sep;35(9):5001-5008.
doi: 10.1007/s00464-020-07979-6. Epub 2020 Oct 1.

Short-term outcomes of robotic-assisted laparoscopic versus laparoscopic lateral lymph node dissection for advanced lower rectal cancer

Hajime Morohashi  1 , Yoshiyuki Sakamoto  2 , Takuya Miura  2 , Takuji Kagiya  2 , Kenta Ogasawara  2 , Yoshiya Takahashi  2 , Kentaro Sato  2 , Yutaro Hara  2 , Hirokazu Ogasawara  2 , Kenichi Hakamada  2
Affiliations

Short-term outcomes of robotic-assisted laparoscopic versus laparoscopic lateral lymph node dissection for advanced lower rectal cancer

Hajime Morohashi et al. Surg Endosc. 2021 Sep.

Abstract

Background: Therapeutic strategies to suppress local recurrence, including lateral lymph node metastasis, are important to improve the curability of rectal cancer. The aim of the present study was to clarify the advantages of robotic-assisted laparoscopic lateral lymph node dissection (RALLD), comparing its short-term outcomes with those of laparoscopic lateral lymph node dissection (LLLD). There are some retrospective reports comparing RALLD or LLLD and open lateral lymph node dissection (OLLD), but few reports comparing RALLD and LLND to each other.

Methods: From November 2014 to August 2020, we compared the short-term outcomes in 40 patients who underwent RALLD and 55 patients who underwent LLLD.

Results: The total operative time was significantly longer in the RALLD group than in the LLLD group (p < 0.001). However, lateral dissection time was not significantly different between the groups (p = 0.661). The postoperative hospital time was shorter in the RALLD group than in the LLLD group (p < 0.048). No significant differences were identified in the rates of postoperative bleeding, incisional surgical site infection (SSI), organ/space SSI, urinary disfunction, urinary infection, or small bowel obstruction between the groups. However, anastomotic leakage was significantly lower in the RALLD group than in the LLLD group (p = 0.031).

Conclusions: The short-term outcomes of RALLD indicate it is feasible, and RALLD may be a useful modality for lower rectal cancer.

Keywords: Lateral lymph node dissection; Rectal cancer; Robotic-assisted laparoscopic surgery.

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Conflict of interest statement

Dr. Hajime Morohashi, Yoshiyuki Sakamoto, Takuya Miura, Takuji Kagiya, Kenta Ogasawara, Yoshiya Takahashi, Kentaro Sato, Yutaro Hara, Hirokazu Ogasawara, and Kenichi Hakamada have no conflicts of interest or financial ties to disclose.

Figures

Fig. 1
Fig. 1
Flowchart of patients. RALLD robotic-assisted laparoscopic lateral lymph node dissection. LLLD laparoscopic lateral lymph node dissection
Fig. 2
Fig. 2
Intraoperative view after right side lateral lymph node dissection of the a the internal lymph node area and b the obturator lymph node area
See this image and copyright information in PMC

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