No beneficial effect on survival but with a decreased postoperative adverse events for robotic surgery in patients with rectal cancer: A retrospective cohort study

Abstract

Aim To compare the oncologic outcomes in patients with rectal cancer receiving robotic vs. laparoscopic surgery. Methods The clinical data of patients with rectal cancer receiving robotic surgery (Robot group, n = 317) or laparoscopic surgery (Laparoscopy group, n = 224) were collected for outcomes assessment. The primary endpoints were the survival outcome. The secondary outcomes were postoperative adverse events and pathologic characteristics. Results Patients in the Robot group have significantly shorter operation time (163.6 ± 41.1vs.190.6 ± 52.5min), shorter time to 1st gas passing [2(1)vs.3(1)d] and shorter hospital day [7(2)vs.8(3)d], compared to those in Laparoscopy group (P < 0.001, respectively). The incidence of urinary retention short- and long term in Robot group is significant lower than in Laparoscopy group (1.9% vs. 10.7%; 0.6% vs. 4.0%, P < 0.05, respectively). TNM stage II and III was more frequently observed in the Robot group than that in the Laparoscopy group (94.3% vs. 83.5%), whereas stage I was more common in the Laparoscopy group than in the Robot group (5.7% vs. 16.5%). No significant difference in the overall survival (OS) and disease-free survival (DFS) were observed in Robot group and Laparoscopy group at 1-, 3- and 5-year. By a multivariable-adjusted analysis, the robotic surgery was not an independent prognostic factor for OS and DFS. Conclusions A beneficial effect on survival of the robotic surgery for rectal cancer could not be demonstrated. However, the robot is a feasible surgical procedure due to the decreased postoperative adverse event.