Rectal cancer management during the COVID-19 pandemic (ReCaP): multicentre prospective observational study (original) (raw)
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Robotic Surgery for Rectal Cancer: Initial Experience from 30 Consecutive Patients
Journal of …, 2011
Background Robotic surgery offers 3D visualization and the advantage of the usage of multi-articulated instruments with superior dexterity. Theoretically, it can overcome many limitations of laparoscopic rectal surgery in the narrow pelvis. Materials and Methods Between January 2010 and January 2011, the patients who underwent robotic rectal resection for cancer were retrospectively evaluated in terms of demographics, operative data, complications, the duration of hospital stay, and histopathological data. Results Thirty consecutive patients made up of 13 female and 17 male patients underwent robotic rectal resection. Sphincter-saving mesorectal excision was performed in 27 patients. Of these, there were 19 total and 8 partial mesorectal excisions. The mean operative time was 270 min (175-480 min). The median postoperative hospital stay was 4 days (4-20 days). No operation was converted. The complication rate was 13.3%. One patient died due to colonic necrosis caused by Drummond artery deficiency (3.3%). The median number of harvested lymph nodes was 15 (3-38), and the distal resection margin was 4 cm (2-8). Histopathological evaluation revealed that the mesorectum resection was complete in all patients. Conclusion Robotic rectal surgery (hybrid or totally robotic) is a safe and feasible procedure when performed by experienced laparoscopic surgeons.
Dealing with robot-assisted surgery for rectal cancer: Current status and perspectives
World journal of gastroenterology, 2016
The laparoscopic approach for treatment of rectal cancer has been proven feasible and oncologically safe, and is able to offer better short-term outcomes than traditional open procedures, mainly in terms of reduced length of hospital stay and time to return to working activity. In spite of this, the laparoscopic technique is usually practised only in high-volume experienced centres, mainly because it requires a prolonged and demanding learning curve. It has been estimated that over 50 operations are required for an experienced colorectal surgeon to achieve proficiency with this technique. Robotic surgery enables the surgeon to perform minimally invasive operations with better vision and more intuitive and precise control of the operating instruments, thus promising to overcome some of the technical difficulties associated with standard laparoscopy. It has high-definition three-dimensional vision, it translates the surgeon's hand movements into precise movements of the instrument...
Chirurgia
Cancerul colorectal este o cauză majoră de morbiditate şi mortalitate la nivel global. Aproximativ unul din trei cancere colorectale diagnosticate este un cancer rectal. Progresele recente în domeniul chirurgiei rectale au promovat utilizarea roboţilor chirurgicali. Exploatarea lor devine de mare importanţă atunci când chirurgii se confruntă cu dificultăţi anatomice, precum un pelvis masculin îngust, o tumoră voluminoasă sau pacienţi obezi. Acest studiu îşi propune să evalueze rezultatele clinice ale chirurgiei robotice în cancerul rectal în perioada de introducere a unui sistem robotic chirurgical. Din decembrie 2019, Departamentul de Chirurgie al Spitalului Universitar din Varna a devenit cel mai nou şi cel mai modern Centru de Competenţă în Chirurgia Robotică din Bulgaria, dotat cu cel mai avansat sistem chirurgical da Vinci Xi. Din ianuarie 2020 până în octombrie 2020, un număr total de 43 de pacienţi au fost supuşi unui tratament chirurgical, dintre care 21 au avut proceduri asistate de robot şi restul au fost proceduri deschise. Caracteristicile pacienţilor au fost similare între grupurile studiate. Vârsta medie a pacientului în chirurgia robotică a fost de 65 de ani, şase dintre aceşti pacienţi fiind femei. În cazul intervenţiei chirurgicale deschise vârsta medie a fost de 70 de ani, 6 pacienţi fiind femei. 66,7% dintre pacienţii operaţi cu da Vinci Xi au avut tumori în stadiul 3 sau 4, iar aproximativ 10% au avut neoplasm
The role of the robotic technique in minimally invasive surgery in rectal cancer
Ecancermedicalscience, 2013
Laparoscopic rectal surgery is feasible, oncologically safe, and offers better short-term outcomes than traditional open procedures in terms of pain control, recovery of bowel function, length of hospital stay, and time until return to working activity. Nevertheless, laparoscopic techniques are not widely used in rectal surgery, mainly because they require a prolonged and demanding learning curve that is available only in high-volume and rectal cancer surgery centres experienced in minimally invasive surgery. Robotic surgery is a new technology that enables the surgeon to perform minimally invasive operations with better vision and more intuitive and precise control of the operating instruments, promising to overcome some of the technical difficulties associated with standard laparoscopy. The aim of this review is to summarise the current data on clinical and oncological outcomes of minimally invasive surgery in rectal cancer, focusing on robotic surgery, and providing original data...
The Robotic Approach in Rectal Cancer
Current Topics in Colorectal Surgery [Working Title], 2021
Since a robotic surgical system was developed in the early 1990s and the first robotic-assisted radical prostatectomy was reported in 2001, robotic surgery has spread in many surgical specialties, changing surgical management. Currently, compared to other colorectal procedures, robotic surgery appears to offer great benefits for total mesorectal excision for rectal cancer. Abdominal cavity other procedures such as right hemicolectomy and high anterior resection are relatively uncomplicated and can be performed easily by laparoscopic surgery. First reports have focused on the clinical benefits of robotic rectal cancer surgery compared with laparoscopic surgery. The indications for robotic and laparoscopic rectal cancer surgery are not different. The recently published results of the ROLARR trial, comparing robot-assisted TME to laparoscopic TME, show no advantages of robot assistance in terms of intraoperative complications, postoperative complications, plane of surgery, 30-day morta...
Is robotic rectal resection the preferred option for resectable cancer
Mini-invasive Surgery , 2018
The ultimate goal of rectal cancer surgery is to achieve a negative circumferential, distal resection margin and intact mesorectal excision; however, controversy remains as to what is the best approach. Based on the current evidence, open surgery remains the "gold standard", however recent improvements in minimally invasive surgery (MIS) techniques with the introduction of robotic surgery and transanal total mesorectal excision have questioned the historical approach of open rectal dissection. A robotic system (da Vinci) overcomes many of the limitations of laparoscopic surgery. A robotic system is more like an open surgery: it gives a 3-dimensional magnified view, endowrist movements, has a shorter learning curve when compared with laparoscopic surgery, with the added advantage of an MIS procedure. However, the higher cost associated with robotic surgery has limited uptake of this approach in rectal cancer surgery in many parts of world.
2015
The conventional laparoscopic approach to rectal surgery has several limitations, and therefore many colorectal surgeons have great expectations for the robotic surgical system as an alternative modality in overcoming challenges of laparoscopic surgery and thus enhancing oncologic and functional outcomes. The aim of this study was to evaluate the feasibility and short-term outcomes of robotic surgery for colorectal cancer as initial cases, compared with conventional laparoscopic surgery. From July 2015 to October 2015, fifteen patients with left-sided colon and rectal cancer underwent robotic surgery, and we compare with 20 patients received conventional laparoscopic surgery selected from our database of 153 patients with colorectal cancer operated in the last five years. Both groups were balanced in terms of age, gender, American Society of Anesthesiologists (ASA) score, body mass index (BMI), operative history, TNM staging, and tumor location using the propensity score matching me...
Robotic Low Anterior Resection for Rectal Cancer
Annals of Surgery, 2015
This study examines short-term outcomes and pathologic surrogates of oncologic results among patients undergoing robotic versus laparoscopic low anterior resection for rectal cancer. A total of 6403 patients met inclusion criteria. Although the robotic approach required significantly fewer conversions to open, surrogates for proper oncologic surgery were nearly identical between the 2 approaches. Background: Although laparoscopic low anterior resection (LLAR) has gained popularity as an acceptable approach, the robotic low anterior resection (RLAR) remains largely unproven. We compared short-term oncologic outcomes between rectal cancer patients undergoing either RLAR or LLAR. Study Design: All patients with rectal cancer in the National Cancer Data Base undergoing RLAR or LLAR from 2010 to 2011 were included. Predictors of RLAR were modeled with multivariable logistic regression. Groups were matched on propensity to undergo RLAR. Primary endpoints included lymph node retrieval and margin status, whereas secondary 30-day outcomes were mortality, hospital length of stay (LOS), and unplanned readmission rates. Results: A total of 6403 patients met inclusion criteria, of which 956 (14.9%) underwent RLAR. RLAR patients were more likely to be treated at academic centers, receive neoadjuvant therapy, and have higher T-stage and longer time to surgery (all P < 0.001). Neoadjuvant therapy and treatment at an academic/ research center remained the only significant predictors of robotic use after multivariable adjustment. After propensity matching, RLAR was associated with lower conversion (9.5 vs 16.4%, P < 0.001). There were no significant differences in lymph node retrieval, margin status, 30-day mortality, readmission, or hospital LOS. Conclusions: In this largest series to date, we demonstrated equivalent perioperative safety and patient outcomes for robotic compared to LLAR in the setting of rectal cancer. Although the robotic approach required significantly fewer conversions to open, surrogates for proper oncologic surgery were nearly identical between the 2 approaches, suggesting that a robotic approach may be a suitable alternative. Further studies comparing long-term cancer recurrence and survival should be performed.