A Comparison of Short-term Outcomes for Open, Laparoscopic, and Robotssisted Rectal Resection for Cancer

Introduction: In recent years, robotic-assisted surgery using the da Vinci System® has been proposed as an alternative to the traditional open or laparoscopic procedures. The aim of this study was to compare the short-term outcomes for open, laparoscopic, and robot-assisted rectal resection for cancer.
Methods: Two hundred sixty-three patients with rectal cancer who underwent curative resection between 2007 and 2009 were included. Patients were divided into an open surgery group (OPEN, n = 88), a laparoscopic surgery group (LAP, n = 123) and a robot-assisted group (ROBOT, n = 52). Data include operative time, length of recovery, methods of specimen extraction, quality of total mesorectal excision, and morbidity.
Results: The mean operation time was 233.8 ± 59.2 for OPEN group, 158.0 ± 49.2 for LAP group and 232.6 ± 52.4 for Robot group (p < 0.001). Patients from the LAP group and ROBOT group recovered significantly faster than those from the OPEN group (p < 0.05). The proportion of cases done by natural orifice surgery-intracorporeal anastomosis with transanal or transvaginal retrieval of specimens-were significantly higher in the ROBOT group (p < 0.001). There were no differences in specimen quality among the three groups, with distal resection margin, harvested lymph node, and circumferential margin. The overall complication rate in OPEN, LAP, and ROBT group were 20.5, 11.4, and 19.2% (p = 0.160).
Conclusions: Robot-assisted rectal resection is equivalent to open and laparoscopy approach with respect to short-term outcomes. Furthermore, the technical advantages of robot surgical system are helpful to adopt a method of natural orifice surgery.


Session: Podium Presentation

Program Number: S052

« Return to SAGES 2010 abstract archive