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Open versus robot‐assisted sphincter‐saving operations in rectal cancer patients: techniques and comparison of outcomes between groups of 100 matched patients
Author(s) -
Kim Jin C.,
Yang Sung S.,
Jang Tae Y.,
Kwak Jae Y.,
Yun Myung J.,
Lim Seok B.
Publication year - 2012
Publication title -
the international journal of medical robotics and computer assisted surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.556
H-Index - 53
eISSN - 1478-596X
pISSN - 1478-5951
DOI - 10.1002/rcs.1452
Subject(s) - medicine , colorectal cancer , surgery , dissection (medical) , cancer , stage (stratigraphy) , complication , paleontology , biology
Background Although open resection using a sphincter‐saving operation (SSO) remains the standard of care for rectal cancer, few studies have compared open and robot‐assisted (RA) SSOs. This study aimed to compare the operative features, functional outcomes, and oncological validity of open and RA SSO for rectal cancer. Methods A total of 200 rectal cancer patients undergoing curative SSO were enrolled prospectively. The open and RA groups (n = 100, respectively) were matched for clinical stage and operation type. Results The mean operation time was significantly longer in the RA group than in the open group (188 vs. 103 min, P < 0.001), but it was significantly reduced in the latter half of the RA patients compared with that in the first half (164 vs. 214 min, P < 0.001). The mean distal resection margin was significantly longer in the RA than in the open group (2.7 vs. 1.9 cm; P = 0.001), but only one patient in either group had positive circumferential resection margin. Bowel peristalsis returned one day earlier in the RA than in the open group ( P < 0.001). Postoperative complication rates and anorectal functional outcomes were comparable between the two groups. The operator's physical discomfort, assessed on a visual analog scale, was significantly lower in the RA than in the open group ( P < 0.001). Conclusions According to this short‐term study, the RA SSO showed equivalent oncological safety, functional outcome, and morbidities to open SSO. Although the operation takes longer, the robotic system enables a technically versatile SSO with fine dissection in a limited surgical field. Copyright © 2012 John Wiley & Sons, Ltd.