Robotic Versus Laparoscopic-Assisted Intersphincteric Resection for Low Rectal Cancer: A Comparative Study of Short-term Outcomes

Soo Yeun Park, MD, Gyu-seog Choi, MD, Jun Seok Park, MD, Hye Jin Kim, MD, Jong-pil Ryuk, MD, Whon-ho Choi, MD. Kyungpook National University Medical Center


Introduction The present study aimed to compare the short-term outcomes between robotic-assisted intersphincteric resection (ISR) and laparoscopic ISR for distal rectal cancer
Methods Between March 2008 to July 2011, patients treated by robotic and laparoscopic-assisted ISR for rectal cancer were included in a retrospective comparative study. Preoperative, perioperative, and postoperative data, including complication and early functional outcomes, were analyzed between the two groups. Functional outcomes were evaluated using the Wexner Scoring, the International Prostate Symptom Score (IPSS), and the 5-item version of the International Index of Erectile Function (IIEF-5).
Results 40 patients were treated by robotic and 40 by laparoscopic-assisted ISR. The mean operative time was significantly longer in the robotic group (235.5 vs. 185.4 min; P < 0.001). Trans-abdominal ISR, in which ISR is completed in the pelvic cavity, was performed more often using robotic-assistance than laparoscopic surgery (8 vs. 2 cases; p = 0.043). No difference was observed between groups regarding postoperative morbidity and pathologic outcomes. There was a trend towards fewer postoperative losses and early recovery of functional outcomes in the robotic-assisted group.
Conclusion Robotic-assisted surgery was safe and effective for ISR of distal rectal cancer and resulted in similar surgical outcomes with the latest laparoscopic ISR. The results favored robotic-assisted ISR with respect to functional outcomes and the time required for the surgeon to adapt to the technique.

Session Number: SS12 – Plenary I
Program Number: S067

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