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Robotic Salvage Surgery for the Treatment of Recurrent Rectal Cancer

Hye-Jin Kim, Gyu-Seog Choi, Jun Seok Park, Soo Yeun Park, Sung Min Lee. Kyungpook National University Chilgok Hospital

Background: Robotic approach can be a treatment option for patients with pelvic recurrence after primary resection for rectal cancer. However, data regarding patient selection, complication rates, and oncologic outcomes are rarely reported. We aimed to present initial experience and to evaluate feasibility, safety, and oncologic outcomes of robotic salvage surgery for recurrent rectal cancer.

Methods: Eight patients who underwent robotic salvage surgery for local recurrence at the anastomotic site, lateral pelvic side-wall, or lateral pelvic lymph nodes (LPNs) were retrospectively evaluated from a prospectively maintained database.

Results: Two patients underwent pelvic mass excision with en bloc resection of anastomosis and redo-anastomosis, and six patients underwent lateral pelvic lymph node dissection (LPND) for LPN metastasis; one of these six patient underwent additional en bloc resection of anastomosis. All patients achieved R0 resection. The median operation time was 165 min and the median estimated blood loss was 50 ml. There were no conversions. As for intraoperative complications, one patient experienced ureter injury during LPND because the metastatic LPN was closely abutting to the ureter. The median hospital stay was 7 days. In six patients who underwent LPND, the median number of harvested lymph nodes was 7 (range 2-13) and the median number of metastatic lymph nodes was 1 (range 0-2). With median follow-up 26 months, one patient developed lung and pelvic recurrence at 36 months after salvage operation and seven patients remained in disease-free state at the last follow-up.

Conclusion: Initial experience of robotic salvage surgery for pelvic recurrence in rectal cancer indicated that it is safe and feasible. Therefore, the robotic approach can be considered as a treatment option for the treatment of local recurrence in highly selected patients. 


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

Abstract ID: 95185

Program Number: P699

Presentation Session: Poster Session (Non CME)

Presentation Type: Poster

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