Savulescu Florin, MD, PhD, Cirlan Cristian, MD, Blajut Cristian, MD, Budrugeac Iulia, MD, Iordache Mihai, MD, Iordache-Petrescu Madalina, MD. Dr. Carol Davila Central Military Emergency University Hospital
Background: Minimally invasive techniques have revolutionized the field of general surgery over the few last decades. The available literature on minimally invasive colorectal cancer surgery demonstrates that this approach is feasible and associated with better short term outcomes than open surgery while maintaining equivalent oncologic safety. Despite its advantages, in complex procedures such as rectal surgery, laparoscopy has not achieved a high penetration rate because of its steep learning curve, its relatively high conversion rate and technical challenges. Robotic-assisted surgery has been evolving now for over two decades and has finally matured into a technology that has caused a monumental shift in the way colorectal surgeries are performed.The aim of this study was to present a single center experience with robotic surgery for rectal cancer focusing mainly on early and mid-term postoperative outcome.
Methods: A series of 75 consecutive patients who underwent robotic rectal surgery between December 2014 and July 2018 in “Dr. Carol Davila” Central Military Emergency University Hospital, in Bucharest, Romania was analyzed retrospectively in terms of demographics, pathological data, surgical and oncological outcomes.
Results: Seventy-two patients underwent robotic sphincter-saving resection, and three patients underwent robotic abdominoperineal resection. There ware two conversions. The median operative time for sphincter-saving procedures was 210 minutes. The median time for robotic abdominoperineal resection was 180 minutes. The median number of retrieved lymph nodes was 22. The median hospital stay was 6 days. In-hospital mortality was nil. The overall morbidity was 20%. The median length of follow-up was 23 months.
Conclusion: Our preliminary results suggest that robotic-assisted surgery for colorectal cancer can be carried out safely and according to oncological principles. Robotic surgery is advantageous for both surgeons (in that it facilitates dissection in a narrow pelvis) and patients (in that it affords a very good quality of life via the preservation of sexual and urinary function in the vast majority of patients and it has low morbidity and good midterm oncological outcomes). In rectal cancer surgery, the robotic approach is a promising alternative and is expected to overcome the low penetration rate of laparoscopy in this field.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94389
Program Number: P367
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster