Hye Jin Kim, Gyu-Seog Choi, Jun Seok Park, Soo Yeun Park, Hee Jae Lee. Kyungpook National University Medical Center, Daegu, Korea
Background: Lateral pelvic lymph node dissection (LPND) is a challenging procedure due to its technical difficulty and higher incidence of surgical morbidity. The present study compared short-term outcomes between laparoscopic and robotic LPND in patients with rectal cancer.
Methods: Between May 2006 and December 2014, prospectively collected data from consecutive patients who underwent robotic or laparoscopic total mesorectal excision (TME) with LPND were retrospectively compared. Data regarding patients’ demographics, perioperative outcomes, functional results, and initial oncologic outcomes were analyzed.
Results: Fifty and 35 patients underwent robotic or laparoscopic TME with LPND, respectively. Bilateral LPND was performed in 10 patients (20%) in the robotic group and 6 (17.1%) in the laparoscopic group. For unilateral pelvic dissection, the mean operative time was not significantly different between the groups (robotic vs. laparoscopic group, 41.0 ± 15.8 min vs. 35.3 ± 13.4 min; P = 0.146), but the estimated blood loss was significantly lower in the robotic group (34.6 ± 21.9 mL vs. 50.6 ± 23.8 mL; P = 0.002). Two patients (4.0%) in the robotic group and 7 (30.4%) in the laparoscopic group experienced Foley catheter reinsertion for urinary retention, postoperatively (P = 0.029). Impaired urinary function, analyzed by the total International Prostate Symptom Score postoperatively, was lower in the robotic group. The mean number of harvested lateral pelvic lymph nodes was 6.6 (range, 0-25) in the robotic group and 6.4 (range, 1-14) in the laparoscopic group. During the median follow-up of 26.3 months, 2 patients in the robotic group and 4 in the laparoscopic group had local recurrences.
Conclusions: Robotic TME with LPND is safe and feasible with favorable short-term surgical outcomes. However, further large cohort studies with a long-term follow-up are warranted.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80896
Program Number: S069
Presentation Session: Robotics
Presentation Type: Podium
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