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Clinical Trial
. 2024 May 8;8(3):zrae048.
doi: 10.1093/bjsopen/zrae048.

Feasibility of robotic-assisted surgery in advanced rectal cancer: a multicentre prospective phase II study (VITRUVIANO trial)

Atsushi Hamabe  1   2 , Ichiro Takemasa  2 , Masanori Kotake  3 , Daisuke Nakano  4 , Suguru Hasegawa  5 , Akio Shiomi  6 , Masakatsu Numata  7 , Kazuhiro Sakamoto  8 , Kei Kimura  9 , Tsunekazu Hanai  10 , Takeshi Naitoh  11 , Yosuke Fukunaga  12 , Yusuke Kinugasa  13 , Jun Watanabe  14 , Junichiro Kawamura  15 , Mayumi Ozawa  16 , Koji Okabayashi  17 , Shuichiro Matoba  18 , Yoshinao Takano  19 , Mamoru Uemura  1 , Yukihide Kanemitsu  20 , Yoshiharu Sakai  21 , Masahiko Watanabe  22
Affiliations
Clinical Trial

Feasibility of robotic-assisted surgery in advanced rectal cancer: a multicentre prospective phase II study (VITRUVIANO trial)

Atsushi Hamabe et al. BJS Open. .

Abstract

Background: The potential benefits of robotic-assisted compared with laparoscopic surgery for locally advanced cancer have not been sufficiently proven by prospective studies. One factor is speculated to be the lack of strict surgeon criteria. The aim of this study was to assess outcomes for robotic surgery in patients with locally advanced rectal cancer with strict surgeon experience criteria.

Methods: A criterion was set requiring surgeons to have performed more than 40 robotically assisted operations for rectal cancer. Between March 2020 and May 2022, patients with rectal cancer (distance from the anal verge of 12 cm or less, cT2-T4a, cN0-N3, cM0, or cT1-T4a, cN1-N3, cM0) were registered. The primary endpoint was the rate positive circumferential resection margin (CRM) from the pathological specimen. Secondary endpoints were surgical outcomes, pathological results, postoperative complications, and longterm outcomes.

Results: Of the 321 registered patients, 303 were analysed, excluding 18 that were ineligible. At diagnosis: stage I (n = 68), stage II (n = 84) and stage III (n = 151). Neoadjuvant therapy was used in 56 patients. There were no conversions to open surgery. The median console time to rectal resection was 170 min, and the median blood loss was 5 ml. Fourteen patients had a positive CRM (4.6%). Grade III-IV postoperative complications were observed in 13 patients (4.3%).

Conclusion: Robotic-assisted surgery is feasible for locally advanced rectal cancer when strict surgeon criteria are used.

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Figures

Fig. 1
Fig. 1
Flow of patient inclusion in the VITRUVIANO trial
See this image and copyright information in PMC

References

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