Robotic-assisted total mesorectal excision (TME) for rectal cancer results in a significantly higher quality of TME specimen compared to the laparoscopic approach—report of a single-center experience

Aselmann, H.; Kersebaum, Jan-Niclas; Bernsmeier, A; Beckmann, Jan; Möller, Thorben; Egberts, Jan Hendrik; Schafmayer, Clemens; Röcken, Christoph; Becker, Thomas

doi:10.1007/s00384-018-3111-x

Cited by 40 publications

(35 citation statements)

References 24 publications

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“…The pooled data showed no significant difference was observed between robotic group (1.89%, 18/950) and laparoscopic group (1.77%, 17/960) (OR = 1.12, 95% CI 0.58-2.17, P = 0.74), with no significant heterogeneity among the studies (I 2 = 0%, P = 0.79). Of the 8 studies, 3 studies [19,25,26] clearly reported the site of bleeding in the anastomotic stoma, with an incidence of 3.30% (7/212) in RS group and 5.63% (9/160) in LS group. The meta-analysis showed no significant difference (OR = 0.64, 95% CI 0.23-1.77, P = 0.39) and no heterogeneity (I 2 = 0%, P = 0.81).…”

Section: Plos Onementioning

confidence: 99%

The severity of postoperative complications after robotic versus laparoscopic surgery for rectal cancer: A systematic review, meta-analysis and meta-regression

et al. 2020

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Objective Robotic surgery (RS) has been increasingly used for the resection of rectal cancer, and its advantages over laparoscopic surgery (LS) have been demonstrated. However, few studies focused on the severity of postoperative complications. This study aimed to compared the postoperative complications within 30 days after RS over LS according to the Clavien-Dindo (C-D) classification. Methods A literature research of PubMed, Embase, Cochrane Library and Web of Science were systematically performed. The studies comparing the complications of RS and LS for rectal cancer based on the C-D classification were enrolled. Primary outcomes were C-D grade III, IV, V, III-V (severe complications). Results Seventeen studies (3193 patients) were included in the final analysis: 1554 underwent RS and 1639 underwent LS. The RS group was associated with significantly lower rates of severe complications (OR = 0.69, 95% CI 0.53-0.90, P = 0.005), C-D grade IV (OR = 0.69, 95% CI 0.53-0.90, P = 0.005), and anastomotic leak (OR = 0.66, 95% CI 0.48-0.91, P = 0.01). There was no significant difference in C-D grade III, C-D grade I, II, I-II (minor complications), overall complications, bleeding, wound complications, postoperative ileus, urinary retention, readmission, reoperation between two groups.

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Section: Plos Onementioning

confidence: 99%

The severity of postoperative complications after robotic versus laparoscopic surgery for rectal cancer: A systematic review, meta-analysis and meta-regression

et al. 2020

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“…After removing duplicates, 739 publications were further reviewed. Further screening found that 23 studies [15][16][17][18][19][20][21][22][24][25][26][27][28][29][30][31][32][33][34][35][36]47,48 met the predefined inclusion criteria. The selection process is reported in Figure 2.…”

Section: Literature Search and Study Characteristicsmentioning

confidence: 99%

“…The selection process is reported in Figure 2. Among the included studies, eight were prospective, 24,25,28,29,32,34,35,48 and 15 retrospective. [15][16][17][18][19][20][21][22]26,27,30,31,33,36,47 F I G U R E 1 Network geometry for studies reporting A, complete mesorectum excision; B, near complete mesorectum excision; C, incomplete mesorectum; D, radial margin involvement; E, lymph node harvest; F, local recurrence; G, distal recurrence; H, overall complication rate; I, anastomotic leak; L, wound infection; M, urinary dysfunction; N, bowel obstruction; O, reoperation; and P, 30-day mortality.…”

Section: Literature Search and Study Characteristicsmentioning

confidence: 99%

Systemic review and network meta‐analysis comparing minimal surgical techniques for rectal cancer: quality of total mesorectum excision, pathological, surgical, and oncological outcomes

Rausa

Bianco

Kelly

et al. 2019

Journal of Surgical Oncology

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Background Minimal invasive surgery has revolutionized recovery in rectal cancer patients. However, there has been debate on its effect on quality of total mesorectal excision (TME) and oncological outcomes. This network meta‐analysis compares laparoscopic, robotic‐assisted, and transanal TMEs. This study shows that All three surgical techniques are comparable across TME quality and oncological outcomes. Ultimately, good outcomes are based on each individual surgeon choosing an approach based on their expertise.

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“…In the current study, 19 patients (90.6%) were classi ed as the grading of "complete" in the R-TME group. Similarly, in the literature, Kim et al [28] reported 32 "complete" patients (97.0%) and Aselmann et al [29] reported 43 "complete" patients (97.7%). However, the high-quality evidence from the ROLLAR trail showed that 178 patients (75.4%) were classi ed as "complete" [19], signi cantly lower than our result.…”

Section: Discussionmentioning

confidence: 72%

Comparison of short-term outcomes between Chinese surgical robot “Micro Hand S” assisted and laparoscopic total mesorectal excision for rectal cancer

Wang¹,

Wang²,

Li³

et al. 2020

Preprint

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Background As the first domestically produced Chinese surgical robot for clinical use, the Micro Hand S robot has been applied to total mesorectal excision (TME) for rectal cancer in our center since 2017. The aim of this study was to evaluate the safety and feasibility of the Micro Hand S robot-assisted TME (R-TME) in comparison with laparoscopic TME (L-TME).Methods Between May 2017 and February 2018, patients who underwent R-TME and L-TME in the Third Xiangya Hospital were prospectively included in this study. The data including intraoperative outcomes, postoperative outcomes, pathological outcomes, and functional outcomes were analyzed and compared.Results Totally, 30 patients underwent L-TME and 21 patients underwent R-TME. The patient characteristics of the two groups were similar. Regarding intraoperative and postoperative outcomes, the R-TME group had significantly less blood loss (95.2 vs. 130.0 ml, p = 0.022), shorter time to first flatus (2.1 vs. 2.9 d, p = 0.017) and first liquid intake (2.8 vs. 3.7 d, p = 0.027) than the L-TME group. There were no significant difference in the operative time, conversion, protective ileostomy, length of hospital stay, pain score, complications, and 30-day mortality between the two groups (p > 0.05). In addition, the pathological and functional outcomes also did not differ significantly.Conclusion The Micro Hand S robot-assisted total mesorectal excision is safe and feasible for rectal cancer. However, prospective and large sample size trials are needed to further confirm this conclusion.Trial registration:Clinicaltrial.gov, NCT02752698, Registered on 27 April 2016, https://clinicaltrials.gov/ct2/show/study/NCT02752698?term=Micro+hand&cntry=CN&draw=2&rank=1

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Robotic-assisted total mesorectal excision (TME) for rectal cancer results in a significantly higher quality of TME specimen compared to the laparoscopic approach—report of a single-center experience

Abstract: Robotic surgery is safe and can improve the quality of TME for rectal cancer compared to laparoscopy. Any effect on long-term survival remains to be established.

Cited by 40 publications

References 24 publications

The severity of postoperative complications after robotic versus laparoscopic surgery for rectal cancer: A systematic review, meta-analysis and meta-regression

The severity of postoperative complications after robotic versus laparoscopic surgery for rectal cancer: A systematic review, meta-analysis and meta-regression

Systemic review and network meta‐analysis comparing minimal surgical techniques for rectal cancer: quality of total mesorectum excision, pathological, surgical, and oncological outcomes

Comparison of short-term outcomes between Chinese surgical robot “Micro Hand S” assisted and laparoscopic total mesorectal excision for rectal cancer

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