Enhanced recovery and reduced conversion rates in robotic rectal cancer surgery: a single-center retrospective cohort study.

Autor: Weigl MP; Department of General and Thoracic Surgery, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6800, Feldkirch, Austria., Attenberger C; Private University in the Principality of Liechtenstein (UFL), Triesen, Principality of Liechtenstein.; Institute of Medical Physics, Academic Teaching Hospital, Feldkirch, Austria., Feurstein B; Department of General and Thoracic Surgery, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6800, Feldkirch, Austria., Jäger T; Department of Surgery, Paracelsus Medical University, Salzburg, Austria., Emmanuel K; Department of Surgery, Paracelsus Medical University, Salzburg, Austria., Clemens P; Department of Radio-Oncology, Academic Teaching Hospital, Feldkirch, Austria., Mink S; Private University in the Principality of Liechtenstein (UFL), Triesen, Principality of Liechtenstein.; Central Medical Laboratories, Feldkirch, Austria., Kowatsch M; Private University in the Principality of Liechtenstein (UFL), Triesen, Principality of Liechtenstein., Königsrainer I; Department of General and Thoracic Surgery, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6800, Feldkirch, Austria., Tschann P; Department of General and Thoracic Surgery, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6800, Feldkirch, Austria. peter.tschann@lkhf.at.; Department of Surgery, Paracelsus Medical University, Salzburg, Austria. peter.tschann@lkhf.at.
Jazyk: angličtina
Zdroj: Langenbeck's archives of surgery [Langenbecks Arch Surg] 2024 Aug 29; Vol. 409 (1), pp. 264. Date of Electronic Publication: 2024 Aug 29.
DOI: 10.1007/s00423-024-03453-2
Abstrakt: Purpose: This study aimed to compare the outcomes of robotic-assisted rectal resection with conventional laparoscopic and open approaches, focusing on complication rates, conversion rates, length of hospital stay, and oncologic outcomes.
Methods: A retrospective single-center cohort study included 106 patients with non-metastatic rectal cancer (UICC stages I-III) who underwent rectal resection from January 2013 to December 2023. Patients were assigned to open surgery (n = 23), conventional laparoscopic surgery (n = 55), or robotic-assisted surgery (n = 28).
Results: Robotic surgery demonstrated significantly lower conversion rates compared to minimal-invasive surgeries (p = 0.047) and shorter hospital stays (11.5 ± 8 days) compared to open (17.91 ± 12 days) and laparoscopic (17.2 ± 14 days) surgeries (p = 0.001). The quality of the specimen was significantly better (Score 1) in robotic (85.71%) and open (89.09%) cases compared to laparoscopic approaches (47.83%) (p < 0.001). Laparoscopic surgery was identified as a risk factor for worse specimen quality (p < 0.001). Older patients (> 63 years) had a higher risk for conversion in univariate analysis (p = 0.049). Morbidity was comparable between the groups (p = 0.131), and the anastomotic leakage rate did not differ significantly (laparoscopic: 18.18%, open: 13.04%, robotic: 17.86%). Kaplan-Meier survival curves showed no significant differences in overall survival probabilities among the groups.
Conclusion: Robotic-assisted rectal resection provides significant advantages in terms of lower conversion rates, better specimen quality, and shorter hospital stays while maintaining comparable complication rates and oncologic outcomes to conventional laparoscopic and open approaches. These findings support robotic surgery as a standard treatment option for rectal cancer.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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