Wenju Chang, MD, Ye Wei, MD, Yijiao Chen, Tianyu Liu, Jianmin Xu, Professor. Zhongshan Hospital, Fudan University
Introduction: Due to a limited patient sample size, substantial data from the real word on robotic rectal resection (RRR) is lacking. Here, we assess the safety and efficacy of RRR in a large consecutive cases performed at a single institution in China.
Methods and Procedures: From September 2010 to June 2017, a total of 1145 consecutive RRR procedures were performed in patients with stage I-IV disease. We conducted an analysis based on information obtained from a prospectively designed database evaluating surgical complications, urogenital function, and long-term outcomes.
Results: Of the 4 types of RRR performed, 227 (24.2%) were abdominoperineal resections, 365 (31.9%) were high anterior resections, 500 (43.6%) were low anterior resections and 3 (0.3%) were Hartmann resections. Conversion to an open procedure occurred in 5.9% of patients. The overall positive circumferential margin rate was 1.3%. Surgical complication rate and mortality were 16.2% and 0.8% within 30 days of surgery, respectively. Risk factors for surgical complications from RRR included male gender, tumor location, combined organ resection, clinical T category (cT3-4) and perioperative blood transfusions. Mean hospital stay after surgery and hospital cost were 6.3±2.9 days and 10442.5±3321.5 US dollars, respectively. Urinary function and general sexual satisfaction decreased significantly 1 month after surgery for both sexes. Subsequently, both parameters increased progressively, and the values 1 year after surgery were comparable to those measured before surgery. At a median follow-up of 34.6 months, local recurrence and distant metastases occurred in 2.3% and 13.1% of patients, respectively.
Cconclusion: Robotic rectal resection was associated with a low complication rate as well as preserved sexual and urinary function in a nonselected group of patients with rectal tumors.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 91949
Program Number: S057
Presentation Session: Colorectal II – Neoplasia
Presentation Type: Podium