Feasibility of robotic-assisted surgery in advanced rectal cancer: a multicentre prospective phase II study (VITRUVIANO trial).

Autor:	Hamabe A; Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.; Department of Surgery, Surgical Oncology and Science, Sapporo Medical University, Sapporo, Japan., Takemasa I; Department of Surgery, Surgical Oncology and Science, Sapporo Medical University, Sapporo, Japan., Kotake M; Department of Surgery, Koseiren Takaoka Hospital, Takaoka, Japan., Nakano D; Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan., Hasegawa S; Department of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan., Shiomi A; Division of Colon and Rectal Surgery, Shizuoka Cancer Center Hospital, Nagaizumi, Japan., Numata M; Department of Surgery, Yokohama City University, Yokohama, Japan., Sakamoto K; Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan., Kimura K; Division of Lower GI, Department of Gastroenterological Surgery, Hyogo Medical University, Nishinomiya, Japan., Hanai T; Department of Surgery, Fujita Health University, School of Medicine, Toyoake, Japan., Naitoh T; Department of Lower Gastrointestinal Surgery, Kitasato University School of Medicine, Sagamihara, Japan., Fukunaga Y; Gastroenterological Center, Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan., Kinugasa Y; Department of Gastrointestinal Surgery, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan., Watanabe J; Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan., Kawamura J; Department of Surgery, Kindai University Faculty of Medicine, Osakasayama, Japan., Ozawa M; Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan., Okabayashi K; Department of Surgery, Keio University School of Medicine, Tokyo, Japan., Matoba S; Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan., Takano Y; Department of Surgery, Southern TOHOKU Research Institute for Neuroscience, Southern TOHOKU General Hospital, Koriyama, Japan., Uemura M; Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan., Kanemitsu Y; Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan., Sakai Y; Department of Surgery, Osaka Red-Cross Hospital, Osaka, Japan., Watanabe M; Department of Surgery, Kitasato University Kitasato Institute Hospital, Tokyo  Japan.
Jazyk:	angličtina
Zdroj:	BJS open [BJS Open] 2024 May 08; Vol. 8 (3).
DOI:	10.1093/bjsopen/zrae048
Abstrakt:	Background: The potential benefits of robotic-assisted compared with laparoscopic surgery for locally advanced cancer have not been sufficiently proven by prospective studies. One factor is speculated to be the lack of strict surgeon criteria. The aim of this study was to assess outcomes for robotic surgery in patients with locally advanced rectal cancer with strict surgeon experience criteria. Methods: A criterion was set requiring surgeons to have performed more than 40 robotically assisted operations for rectal cancer. Between March 2020 and May 2022, patients with rectal cancer (distance from the anal verge of 12 cm or less, cT2-T4a, cN0-N3, cM0, or cT1-T4a, cN1-N3, cM0) were registered. The primary endpoint was the rate positive circumferential resection margin (CRM) from the pathological specimen. Secondary endpoints were surgical outcomes, pathological results, postoperative complications, and longterm outcomes. Results: Of the 321 registered patients, 303 were analysed, excluding 18 that were ineligible. At diagnosis: stage I (n = 68), stage II (n = 84) and stage III (n = 151). Neoadjuvant therapy was used in 56 patients. There were no conversions to open surgery. The median console time to rectal resection was 170 min, and the median blood loss was 5 ml. Fourteen patients had a positive CRM (4.6%). Grade III-IV postoperative complications were observed in 13 patients (4.3%). Conclusion: Robotic-assisted surgery is feasible for locally advanced rectal cancer when strict surgeon criteria are used. (© The Author(s) 2024. Published by Oxford University Press on behalf of BJS Foundation Ltd.)
Databáze:	MEDLINE
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