Comparison of short‐term outcomes of robotic‐assisted and conventional laparoscopic surgery for rectal cancer: A propensity score‐matched analysis

Abstract

Introduction:The advantages of robotic-assisted laparoscopic surgery (RALS) for rectal cancer remain controversial. This study clarified and compared the short-term outcomes of RALS for rectal cancer with those of conventional laparoscopic surgery (CLS). Methods: The records of 303 consecutive patients who underwent RALS or CLS for rectal adenocarcinoma between November 2016 and November 2021 were analyzed using propensity score-matched analysis. After matching, 188 patients were enrolled in our study to compare short-term outcomes, such as operative results, postoperative complications, and pathological findings, in each group. Results: After matching, baseline characteristics were comparable between groups. Although operative time in the RALS group was significantly longer than in the CLS group (p < 0.0001), the conversion rate to open laparotomy and the postoperative complication rate in the RALS group were significantly lower than in the CLS group (p = 0.0240 and p = 0.0109, respectively). Blood loss was comparable between groups. In the RALS group, postoperative hospital stay and days to soft diet were significantly shorter than those in the CLS group (p = 0.0464 and p < 0.0001, respectively). No postoperative mortality was observed in either group and significant differences were observed in resection margins and number of lymph nodes harvested. Conclusion:Robotic-assisted laparoscopic surgery for rectal cancer was safe, technically feasible, and had acceptable short-term outcomes. Further studies are required to validate long-term oncological outcomes.

Comparing short-term outcomes of robot-assisted and conventional laparoscopic total mesorectal excision surgery for rectal cancer in elderly patients

“…Because patients who are transferred from minimally invasive surgery to open surgery are more prone to postoperative complications and local recurrence, the conversion rate of surgery is one of the key indicators for demonstrating the progress of surgical technology[ 11 ]. In this study, there was no conversion to open surgery in either group, which is similar to the findings of Yamanashi et al [ 12 ]. This benefits from the rich expertise of the surgical team in treating rectal cancer, which also proves the surgical safety of robot-assisted surgery.…”

Propensity score‐matched analysis of the short‐term outcomes of robotic versus laparoscopic surgery for rectal cancer

“…To date, some studies that incorporated propensity score matching have reported on the short-term outcomes of RARS [24][25][26] ; however, few have focused on anal preservation. In a single-institution, retrospective study, Kojima et al 27 showed that, compared with LARS, RARS achieved a significantly greater rate of low anterior resection with sphincter preservation in patients with ultralow rectal cancer.…”

Small Scale, High Precision: Robotic Surgery in Neonatal and Pediatric Patients—A Narrative Review

“…In contrast, laparoscopic surgeries, while generally requiring less anesthesia than open procedures, may still necessitate more compared to robotic-assisted surgeries due to factors such as pneumoperitoneum maintenance and the need for prolonged operative times. Anesthesia considerations in open surgeries, given the invasiveness and potential for greater tissue disruption, often involve higher doses and more comprehensive pain management strategies [ 41 ]. These findings underscore the nuanced approach required in tailoring anesthesia protocols to the specific demands of each surgical modality, emphasizing the importance of individualized patient care [ 39 , 42 ].…”