Robotic Surgery for Rectal Cancer: The First 30 Resection

Chu Matsuda, Katsuki Dannno, Susumu Miyazaki, Kazumasa Fujitani, Masaru Kubota, Junji Kawada, Kazuhiro Iwase, Yasuhiro Tanaka. Osaka General Medical Center

Introduction:

Robotic surgery remains a novel technique in the field of colorectal surgery in Japan. Several small series have examined its safety and feasibility for colorectal surgery. Our aim was to analyze our entire experience and short-term outcomes with robotic surgery for rectal cancer since its introduction at our institution. We assert that this approach is feasible and safe for the patients with rectal cancer.

Material and Methods:

This is a retrospective analysis of prospectively gathered data for all patients who underwent robotic surgery for rectal cancer with the use of single docking technique of Da Vinci S or Si system between November 2012 and October 2014. Clinical, operative and pathologic factors were reviewed and analyzed.

Results

Thirty patients underwent robotic surgery for rectal cancer during the study period. The locations of tumor were 11 upper rectum, 19 lower rectum. The procedure were as follow, high anterior resection in 4, low anterior resection in 22, ISR in 2, APR in 2 patients. The procedures were performed successfully in all cases. Mean age was 67 years, and 66% of the patients were men, and the mean body mass index was 21.9 ( range, 18.5-29.4) kg/m2. Mean operative duration was 316(190-557)minutes. Mean console duration was 191(78-318)minutes. Mean blood loss was 37.8(0-270)ml. Median postoperative stay was 7 (6-16) days. Mean harvest lymph node number was 16.7 (5-40). Surgical margins were negative in all cases. There was no conversion and anastomotic leakage. Morbidity was 1.1%. There was no mortality postoperatively in this series.

Conclusion

In early series of the selected patients, this technique appears to be fesible and safe when performed by surgeons skilled in laparoscopic colorectal surgery. These findings support the use of a robotic approach for patients requiring rectal surgery.

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