Robotic versus laparoscopic coloanal anastomosis with or without intersphincteric resection for rectal cancer

Baek, Se Jin; Alasari, Sami; Jeong, Da Un; Hur, Hyuk; Min, Byung Soh; Baik, Seung Hyuk; Kim, Nam Kyu

doi:10.1007/s00464-013-3014-4

Cited by 107 publications

(108 citation statements)

References 23 publications

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“…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.…”

Section: Resultsmentioning

confidence: 99%

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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: Resultsmentioning

confidence: 99%

“…It remains yet to be demonstrated that the benefits offered by the robot outweigh the additional costs incurred by its use [9,16,19].…”

Section: Discussionmentioning

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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“…We previously in vivo 32: 611-623 (2018) 616 Figure 2. Continued conducted a meta-analysis, by 12 randomized controlled trials, to evaluate and compare the short-and long-term outcomes of LAS and OS for the treatment of patients with rectal cancer (16). The operative time for OS was significantly shorter, by 40.96 min, than that for LAS.…”

Section: Discussionmentioning

confidence: 99%

Meta-analysis of Robot-assisted Versus Laparoscopic Surgery for Rectal Cancer

2018

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Abstract. Background Laparoscopy-assisted surgery (LAS) for colorectal cancer (CRC) was first described in 1991 (1) and has since been widely applied by surgeons to treat patients with CRC. Several randomized trials and meta-analyses described that LAS for colon cancer results in smaller surgical incisions, reducing intraoperative blood loss, shorter recovery and hospital stays, and similarity of morbidity rate in the shortterm, and is oncologically equivalent in the long-term, compared to open surgery (OS) (2, 3). The application of LAS for rectal cancer was controversial in the previous Medical Research Council Conventional versus Laparoscopic-Assisted Surgery In Colorectal Cancer (MRC CLASICC) trial (4). In 2013, the MRC CLASICC indicated that long-term results continue to support the use of LAS for both colonic and rectal cancer (5). In several randomized trials and our meta-analysis, LAS for rectal cancer is described to have the benefits of reducing intraoperative blood loss, earlier resumption of oral intake, and shorter duration of hospital stay in the short-term, and equivalent long-term outcomes, with comparison to OS (6, 7). However, LAS for rectal cancer has technical disadvantages such as inadequate two-dimensional view with a movable video camera, a limited range for maneuver of the long, straight and rigid laparoscopic instruments in the narrow pelvic cavity, and a reduction in tactile sense.Robot-assisted surgery (RAS) for rectal cancer was introduced to compensate for these disadvantages of LAS. Several studies describe safety and feasibility of RAS for rectal cancer after RAS for CRC was first reported in 2002 (8). The advantages of RAS are a stable 3-dimensional view, an increased dexterity for maneuvering instruments with excellent ergonomics, and physiologic tremor filtering. RAS for rectal cancer may be of use to manipulate instruments in the narrow pelvic cavity.The value of RAS for rectal cancer has remained controversial because the short-and long-term outcomes have not been clarified. To accurately evaluate the efficacy of RAS for rectal cancer, the short-and long-term outcomes of RAS for rectal cancer must be compared to those of LAS. However, there were few randomized controlled trials comparing RAS with LAS for rectal cancer. The methodological index for non-randomized studies (MINORS) is a valid instrument for assessing the methodological quality of non-randomized studies, especially for the purposes of 611 This article is freely accessible online.Correspondence to: Hiroshi Ohtani,

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“…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.…”

Section: Eligible Studiesmentioning

confidence: 99%

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

Huang

Zhang

Wang

2016

International Journal of Advanced Robotic Systems

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In order to compare the curative effect of the Da Vinci surgical system (DVSS) with laparoscopic surgery (LS) or open surgery for colorectal resection, literature search was conducted in PubMed, Excerpt Medica Database (Embase), and Cochrane library up to January 15, 2016. Odds ratio (OR) and weighted mean difference with their corresponding 95% confidence intervals were used as effect size for evaluation of different outcomes. In total, 10 studies consisting of 2767 patients were included for the meta-analysis. As a result, there were no significant differences between DVSS and LS/open surgery in the long-term oncologic outcomes (p > 0.05). However, DVSS achieved a significantly lower length of hospital stay and estimated blood loss (EBL), but a longer operation time. Moreover, DVSS showed a significantly reduced conversion to open surgery than LS (OR ¼ 0.19, 95% confidence interval: 0.08-0.48). Subgroup analysis indicated that DVSS had different results in rectal adenocarcinoma and colon cancer subgroups on outcomes of conversion to open surgery and operation time. DVSS is superior to LS/open surgery in length of hospital stay and EBL, but needs longer operation time. Long-term outcomes of DVSS are comparable with the other approaches. From long-term perspective, DVSS has an equivalent effect to the other two techniques.

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Robotic versus laparoscopic coloanal anastomosis with or without intersphincteric resection for rectal cancer

Cited by 107 publications

References 23 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

Meta-analysis of Robot-assisted Versus Laparoscopic Surgery for Rectal Cancer

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

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