Robotic versus laparoscopic anterior resection of sigmoid colon cancer: comparative study of long-term oncologic outcomes

Abstract

BackgroundRobotically assisted colon resection is a new type of surgery for colon cancer. However, the evidence is inadequate for the general adaptation of robotic colon surgery. This study aimed to show the oncologic and perioperative clinical results of robotically assisted anterior resection (R-AR) compared with those of laparoscopically assisted anterior resection (L-AR) for sigmoid colon cancer.MethodsA total of 180 patients (sigmoid colon cancer stages 1–3) were assigned to receive either R-AR (n = 34) or L-AR (n = 146) between April 2006 and September 2008. Patient characteristics, perioperative clinical results, and long-term oncologic outcomes were compared between the two groups.ResultsThe patient characteristics did not differ significantly between the two groups. The mean operation time was 217.6 ± 70.7 min for L-AR versus 252.5 ± 94.9 min for R-AR (p = 0.016). The total postoperative complication rate was 10.3 % for R-AR versus 5.9 % for L-AR (p = 0.281). The 3-year overall survival rate for all the patients was 93.4 % for L-AR versus 92.1 % for R-AR (p = 0.723). The 3-year overall survival rate was 100 % for both L-AR and R-AR in stage 1, 95.5 % for L-AR versus 100 % for R-AR (p = 0.386) in stage 2, and 88.4 % for L-AR versus 72.9 % (p = 0.881) for R-AR in stage 3.ConclusionIn this study, R-AR showed safety and feasibility in terms of perioperative clinical and long-term oncologic outcomes. However, the advanced technologies of R-AR did not translate into better long-term oncologic outcomes compared with L-AR.

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

“…The final analysis included five studies with a total n of 685 patients; of these, 317 patients underwent hybrid robotic resection and 368 underwent laparoscopic resection [8,[15][16][17][18]. Patient demographics and perioperative variables are presented in Table 1.…”

A realist process evaluation of robot-assisted surgery: integration into routine practice and impacts on communication, collaboration and decision-making

“…169 It has also been argued that longer operation duration is related to the lack of tactile information, leading surgeons to move more slowly because they have to rely on visual information only. 177 However, one study found no difference in overall duration because, although the set-up time was significantly longer, this was balanced out by a significantly shorter operative time, which the authors argued was due to the technical advantages that the robot provides to the surgeon. 178 Given the high cost of purchasing and maintaining a robotic system, minimising additional costs associated with increased operation duration was perceived by some as essential for ensuring that RAS is integrated into routine practice.…”

Efficacy of the Da Vinci surgical system in colorectal surgery comparing with traditional laparoscopic surgery or open surgery

“…Then the remaining 42 articles were subjected to full-text examination and the following studies were further eliminated, including 24 articles without longterm oncologic outcomes, seven studies irrelevant to the comparison of DVSS versus LS/open surgery, and one plan. Finally, 10 eligible articles 5,11,[13][14][15][21][22][23][24][25] were included in the present meta-analysis.…”