Journal Article

Short- and long-term outcomes of robotic-assisted laparoscopic surgery for rectal cancer: results of a single high-volume center in Japan

Yamaoka, Yusuke, Hino, Hitoshi, Furuatni, Akinobu, Shiomi, Akio, Yamakawa, Yushi, Manabe, Shoichi, Yamaguchi, Tomohiro, Kinugasa, Yusuke, Kagawa, Hiroyasu

2018

Overview

Purpose Scientific evidence supporting robotic-assisted laparoscopic surgery (RALS) for rectal cancer remains inconclusive because most previous reports were retrospective case series or case-control studies, with few reports focusing on long-term oncological outcomes with a large volume of patients. The aim of this study was to clarify the short- and long-term outcomes of a large number of consecutive patients with rectal cancer who underwent RALS in a single high-volume center. Methods The records of 551 consecutive patients who underwent RALS for rectal adenocarcinoma between December 2011 and March 2017 were examined to reveal the short-term outcomes. The oncological outcomes of the 204 patients who underwent surgery between December 2011 and March 2014 were evaluated. Results Most patients had tumors located in the lower or mid-rectum (86.0%). Only 7.6% of patients underwent neoadjuvant chemoradiotherapy. Lateral lymph node dissection was performed for 191 patients (34.7%). The median operative time was 257 min, median blood loss was 10 mL, and no transfusions were needed. No conversion to open surgery was necessary. Eighteen patients (3.3%) had Clavien-Dindo grade III postoperative complications. Six patients (1.1%) had positive resection margins. The mean follow-up duration of the 204 patients was 43.6 ± 9.8 (months). The 5-year cancer-specific survival rate for stage I/II/III/IV was 100%/100%/100%/not reached, respectively. The 5-year relapse-free survival rate for stage I/II/III/IV was 93.6%/75.0%/77.6%/ not reached, respectively. The rate of local recurrence was 0.5%. Conclusions Our results suggest that RALS is technically feasible for rectal cancer and has good short- and long-term outcomes.

• Publisher: Springer Berlin Heidelberg,Springer,Springer Nature B.V
• Subject: Adenocarcinoma / Adult / Aged / Aged, 80 and over / Body mass index / Cancer surgery / Chemoradiotherapy / Chemotherapy / Clinical trials / Colorectal cancer / Complications / Disease-Free Survival / Dissection / Female / Gastroenterology / Health risk assessment / Hepatology / Humans / Internal Medicine / Japan / Laparoscopic surgery / Laparoscopy / Laparoscopy - adverse effects / Lymph nodes / Lymphatic system / Male / Medicine / Medicine & Public Health / Metastasis / Middle Aged / Original Article / Ostomy / Patient outcomes / Patients / Postoperative / Postoperative Complications - etiology / Proctology / Rectal Neoplasms - pathology / Rectal Neoplasms - surgery / Rectum / Robotic surgery / Robotic Surgical Procedures - adverse effects / Surgery / Surgical anastomosis / Survival / Tomography / Treatment Outcome / Tumors / Veins & arteries