• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy-Coming Soon!
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

COMPARING PATHOLOGIC OUTCOMES FOR ROBOTIC VERSUS LAPAROSCOPIC SURGERY IN RECTAL CANCER RESECTION: AN ANALYSIS OF 7717 PATIENTS

Benjamin Hopkins, MD, Timothy M Geiger, MD, Molly M Ford, MD, Roberta L Muldoon, MD, Alva J Bethurum Jr., Alexander T Hawkins, MD, MPH. Vanderbilt University Medical Center

INTRODUCTION: Margin negative resection of rectal cancer with minimally invasive techniques remains technically challenging.  Robotic surgery, with articulated instruments and improved visualization, has been offered as an advantage to traditional laparoscopy. We hypothesize that a robotic approach will be associated with a higher rate of negative margin resections when compared to a laparoscopic approach.

METHODS AND PROCEDURE: The National Cancer Database (2010-2014) was queried for adults with locally advanced rectal cancer (clinical stage II-III) who underwent neoadjuvant chemoradiation and curative resection to conduct an observational retrospective cohort study of a prospectively maintained database. Exclusion criteria included metastatic disease or an open surgical approach.  Patients were grouped by either robotic (ROB) or laparoscopic (LAP) approach in an intent-to-treat analysis. The primary outcome was negative margin status, which was defined by using a composite of two factors including circumferential resection margin greater than 1 mm and distal margin without tumor. Multivariable regression analysis was used to examine the association between approach (robotic or laparoscopic) and margin, adjusting for patient, hospital and surgical factors. Secondary outcomes included length of stay, readmission and overall survival.

RESULTS: 7717 patients with locally advanced rectal cancer who underwent minimally invasive resection were identified over the study period.  2316 (30%) underwent an attempted robotic approach.  Factors associated with robotic approach included male gender, private insurance, treatment in the mid-west region, treatment at an academic/ research program and abdominal perineal resection. The overall conversion rate was 12.4% and was increased in the laparoscopic group (ROB: 7.7% vs LAP: 15.2%); p<0.001). The was no difference in unadjusted composite negative margin rate (ROB: 93.6% vs LAP: 92.9%; p=0.23).   In an adjusted analysis controlling for patient, hospital and procedural factors, robotic approach was not associated with a higher composite negative margin status (OR 0.88; 95% CI 0.73-1.07; p=0.22).  In adjusted analyses of secondary outcomes, there was no difference between approach in readmission (OR 1.07; 95% CI 0.90-1.27; p=0.44) or 5-year overall survival (HR 1.09; 95% CI 0.92-1.29; p=0.33). The robotic group had a small, but significant decrease in mean length of stay (ROB: 6.3d vs LAP: 6.7d; p<0.001).

CONCLUSION: This well powered analysis supports either a robotic or a laparoscopic approach for resection of locally advanced rectal cancer from a margin perspective. Both approaches appear to have similar readmission and 5-year overall survival rates.  Patients undergoing robotic surgery have a 0.4 day decrease in mean length of stay.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 92764

Program Number: S058

Presentation Session: Colorectal II – Neoplasia

Presentation Type: Podium

52

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2019 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Critical View of Safety (CVS) Challenge QR Code

The SAGES Critical View of Safety Challenge – Donate Your Lap Chole Videos!

The Society of American Gastrointestinal and Endoscopic Surgeons is hosting the first Artificial Intelligence Data Challenge conducted by surgeons. The aim of this challenge is to generate a large and diverse dataset of laparoscopic cholecystectomy videos, annotated with respect to the subcomponents of the Critical View of Safety (CVS). Computer scientists from all over the […]

Respuesta de SAGES al Estudio NordICC sobre el beneficio de las colonoscopias de detección

SAGES desea aclarar los resultados del estudio NordICC y colocarlos en contexto de los esfuerzos de varias agencias nacionales para reducir el riesgo de cáncer colorrectal – la segunda causa de muerte por cáncer más frecuente en los Estados Unidos-, mediante la promoción de la detección y tratamiento oportuno de las lesiones.

SAGES Response to NordICC Study Regarding Benefit of Screening Colonoscopies

The NordICC Study recently published in The New England Journal of Medicine and widely reported on by media outlets has raised questions regarding the benefit of screening colonoscopy in lowering the risk of colorectal cancer and cancer-related deaths among otherwise healthy and symptom-free men and women aged 55 to 64. Provocative headlines and commentaries have […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons