An international, multicentre, prospective, randomised, controlled, unblinded, parallel-group trial of robotic-assisted versus standard laparoscopic surgery for the curative treatment of rectal cancer

Collinson, Fiona; Jayne, David; Pigazzi, Alessio; Tsang, Charles; J, Barrie; Edlin, Richard; Garbett, Christopher; Guillou, Pierre J.; Holloway, Ivana; Howard, Helen; Marshall, Helen; McCabe, Christopher; Pavitt, Sue; Quirke, Philip; Rivers, Carly S.; Brown, Julia

doi:10.1007/s00384-011-1313-6

Cited by 244 publications

(132 citation statements)

References 32 publications

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“…They will additionally compare the CRM and pathological involvement rates, the short-and longterm local recurrence rates, as well as long-term DFS and OS. The results of this study are greatly anticipated and will provide a significant amount of potentially useful and definitive information about the benefits of robotic surgery for rectal cancer as compared to laparoscopic surgery [27].…”

Section: Oncologic Outcomesmentioning

confidence: 99%

A Review of the Long-Term Oncologic Outcomes of Robotic Surgery Versus Laparoscopic Surgery for Colorectal Cancer

et al. 2015

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The goal of this review was to compare long-term oncologic outcomes of robotic versus laparoscopic resection of colorectal cancer. A literature search was performed using PubMed, EMBASE, Cochrane, and Medline (2002-2014). Search terms: laparoscopic, robotic, rectal, colon, surgery, oncologic, and outcomes. Studies comparing overall and disease free survival of robotic versus laparoscopic surgery for colorectal cancer were included. Meta-analysis was performed using OpenMeta[Analyst] for Windows 8. Five studies were identified reporting on overall survival, disease free survival, lymph node extraction, and distal and circumferential resection margin. Three hundred and seventeen patients underwent robotic resection and 368 underwent laparoscopic resection, with similar demographics. Operative times were longer with robotic resections, with no difference in estimated blood loss (EBL) or length of stay. The disease stage was distributed similarly in both groups. Similar numbers underwent neoadjuvant therapy. Laparoscopic resection was associated with 3.2 mm larger distal resection margins (p=0.04) and 2.2 more lymph nodes removed (p=0.001), but with equivalent circumferential resection margin status. Disease-free and overall survival was equivalent. Robotic and laparoscopic surgery for colorectal cancer offer comparable overall and disease free survival. Laparoscopic surgery offered a slight advantage in operative time, distal margin, and lymph node yield. Larger, prospective trials are needed to confirm the equivalence of these approaches.

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Section: Oncologic Outcomesmentioning

confidence: 99%

A Review of the Long-Term Oncologic Outcomes of Robotic Surgery Versus Laparoscopic Surgery for Colorectal Cancer

et al. 2015

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“…60 This has been criticized to be due to the lower-than-expected 12.2% conversion rate in the laparoscopic arm -the power calculation for this randomized study had been based on the results of the MRC CLASICC trial. In the only meta-analysis consisting solely of randomized controlled trials, Liao et al showed a significantly lower conversion rate in robotic TME than laparoscopy (OR 0.25, 95% CI 0.07-0.91, p=0.04).…”

Section: Use Of the XI In Tmementioning

confidence: 99%

The da Vinci Xi: a review of its capabilities, versatility, and potential role in robotic colorectal surgery

Ngu¹,

Tsang²,

Koh³

2017

RSRR

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Abstract:The Xi is the latest da Vinci surgical system approved for use in colorectal surgery. With its novel overhead architecture, slimmer boom-mounted arms, extended instrument reach, guided targeting, and integrated auxiliary technology, the Xi manages to address several limitations of earlier models. The versatility of this new system allows it to be implemented in a wide range of colorectal procedures -from complex multiquadrant colectomies to challenging mesorectal dissections in the pelvis. While commonly criticized for its cost and prolonged operative time, robotic colorectal surgery holds the potential for enhanced ergonomics, superior precision, and a reduction in the learning curve involved in training an expert surgeon. This review appraises the existing literature on robotic colorectal surgery while elaborating how the improved capabilities of the Xi serve to usher in a new era of minimally invasive colorectal surgery.

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“…There were no significant differences in operation time, length of hospital stay, time to resume regular diet, postoperative morbidity and mortality, or the oncological accuracy of resection. The ROLARR trial is an ongoing pan-world RCT that is comparing robotic versus laparoscopic resection for rectal cancer that may guide future use of robotic surgery [66].…”

Section: Management Of Early Rectal Cancer and The Malignant Polypmentioning

confidence: 99%

Paradigm Shift in the Management of Rectal Cancer

Rawat

Evans

2014

Indian J Surg

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Surgery for rectal cancer in the pre-Total Mesorectal Excision (TME) era was associated with high local recurrence rates. The widespread adoption of the TME technique together with the addition of neoadjuvant oncological therapies have reduced local failure rates and improved survival for patients with rectal cancer. Advances in our knowledge, better understanding of tumour biology and refinement in minimal access techniques and equipment have significantly changed the management of rectal cancer. This paper reviews these changes and proposes a paradigm shift in how rectal cancer management is conceptualised and treated, such that the treatment of rectal cancer is separated into early tumours (potentially suitable for local excison), TME tumours (optimally managed by TME) and beyond TME tumours (optimally managed by multivisceral resection outside the TME plane).

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An international, multicentre, prospective, randomised, controlled, unblinded, parallel-group trial of robotic-assisted versus standard laparoscopic surgery for the curative treatment of rectal cancer

Cited by 244 publications

References 32 publications

A Review of the Long-Term Oncologic Outcomes of Robotic Surgery Versus Laparoscopic Surgery for Colorectal Cancer

A Review of the Long-Term Oncologic Outcomes of Robotic Surgery Versus Laparoscopic Surgery for Colorectal Cancer

The da Vinci Xi: a review of its capabilities, versatility, and potential role in robotic colorectal surgery

Paradigm Shift in the Management of Rectal Cancer

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