Real-world comparison of curative open, laparoscopic and robotic resections for sigmoid and rectal cancer-single center experience
Author(s) Ansari S.A.; Javed M.A.; Hedayat F.; Harris C.; Gill M. et al.
Source Journal of Robotic Surgery; 2021
There has been an increase in the utilization of robotic surgery in addition to traditional open or laparoscopic approaches. Aim of this study is to compare the short-term outcomes for open, laparoscopic, and robotic surgery for rectal and sigmoid cancer. One hundred and forty-seven patients (open n = 48, laparoscopic n = 49, robotic n = 50) undergoing curative resections by two surgeons between 2013 and 2020 were included. Data analyzed included patient demographics, tumor characteristics, length of stay, post-operative outcomes, and pathologic surrogates of oncologic results, including total mesorectal excision (TME) quality, circumferential resection margin (CRM) involvement and lymph node (LN) yield. Median age of population was 68 years (IQR 59-73), majority (68%) were males. Median distance from anal verge in the robotic surgery group was 8 cm, compared to 15 and 14.5 cm in the open and laparoscopic groups, respectively, p = 0.029, (laparoscopic vs robotic, p = 0.005 and open vs robotic, p = 0.027). Proportion of patients who received neoadjuvant radiotherapy in robotic surgery group was higher, p = 0.04. In sub-group of tumors between 3 and 7 cm from anal verge more patients in the robotic surgery group had sphincter preservation, p = 0.006. Length of stay, maximum C-reactive protein, and white blood cell rise favored minimally invasive approaches compared to open surgery. There were no differences in post-operative complications, lymph node yield or CRM positivity rate between the three groups. Robotic surgery approach is safe and allows sphincter preservation without compromising TME quality in rectal cancer surgery.Copyright © 2021, The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.
The following databases were searched:
EMBASE, MEDLINE, PsycINFO, BNI, CINAHL,
to find ELHT staff publications
Archives - past 2 years
Learning Centre Library
Royal Blackburn Teaching Hospital
01254 734312 or Ext 84312
Burnley General Teaching Hospital
01282 803114 or Ext. 13114
Staffed Opening Hours
24/7 access to both libraries is available - please see library staff