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Conference Paper: Comparison of short-term outcome between robotic-assisted and laparoscopic total mesorectal excision for mid to low rectal cancer

TitleComparison of short-term outcome between robotic-assisted and laparoscopic total mesorectal excision for mid to low rectal cancer
Authors
Issue Date2015
Citation
The 2015 Annual Scientific Meeting of the American Society of Colon and Rectal Surgeons (ASCRS), Boston, MA., 30 May-3 June 2015. How to Cite?
AbstractBackground: Laparoscopic total mesorectal excision (TME) is a technically challenging procedure. With its three dimensional vision, flexible instruments and powerful retraction, surgical robotic system may serve to be a better tool in performing complex procedures inside a confined bony pelvis. Yet there is a concern for increase in operative cost. This study aim to review and compare the short-term results of laparoscopic TME (L-TME) and robotic-assisted TME (R-TME) in a single centre. Methods: This study is based on a prospectively collected database of patients with mid to low rectal cancer undergoing either L-TME or R-TME from January 2006 to September 2014. Data on patient demographics, intraoperative parameters and short-term outcome were collected. All patients with cancer of rectum within 12cm from the anal verge (AV) were included. Those with multi-organ resections were excluded. Results: During this period, there were a total of 137 and 164 consecutive patients undergoing L-TME and R-TME respectively. The mean age was 66.4±13.2 and 65.7±10.9 years for L-TME and R-TME. The mean tumour distance from AV was 69.3±29.9 and 68.0±29.9mm for L-TME and R-TME. There was no difference between the demographics in terms of sex, American Society of Anesthesiologist score, preoperative radiation and tumour staging. The mean operating time for R-TME was significantly longer, 271.5±66.5 vs 229.2±60.7 min, p=0.00. Difference in terms of blood loss was not significant. Conversion rate of L-TME and R-TME was 2.9% and 1.8%, p=0.71. Sphincter-saving procedure was done in 91.2% of L-TME and 92.1% of R-TME. Mean hospital stay was 8.5±9.4 and 8.0±7.4 days for L-TME and R-TME, p=0.60. Mean distal margin of L-TME and R-TME was 33.4±15.2mm and 31.3±15.9mm, p-=0.25. Positive circumferential radial margin was found in 8.0% of L-TME and 4.9% of R-TME, p=0.34. Complications rate of L-TME and R-TME was 17.5% and 14.0%. In particular, there was a significantly higher percentage of postoperative urinary retentions in L-TME 11.7% vs 4.3%, p=0.02, RR 2.74, 95% CI 1.16–6.46. 30 day mortally L-TME and R-TME was 1.5% and 1.2%, p=0.61. Conclusion: In the treatment of mid to low rectal cancer, robotic-assisted and laparoscopic total mesorectal excision has comparable short–term outcome. Robotic-assisted approach, however, might offer better functional outcome as a result of autonomic nerve preservation.
DescriptionePoster Presentations - Neoplastic Disease: no. P1320
Persistent Identifierhttp://hdl.handle.net/10722/213515

 

DC FieldValueLanguage
dc.contributor.authorFoo, C-
dc.contributor.authorLaw, W-
dc.date.accessioned2015-08-04T04:15:00Z-
dc.date.available2015-08-04T04:15:00Z-
dc.date.issued2015-
dc.identifier.citationThe 2015 Annual Scientific Meeting of the American Society of Colon and Rectal Surgeons (ASCRS), Boston, MA., 30 May-3 June 2015.-
dc.identifier.urihttp://hdl.handle.net/10722/213515-
dc.descriptionePoster Presentations - Neoplastic Disease: no. P1320-
dc.description.abstractBackground: Laparoscopic total mesorectal excision (TME) is a technically challenging procedure. With its three dimensional vision, flexible instruments and powerful retraction, surgical robotic system may serve to be a better tool in performing complex procedures inside a confined bony pelvis. Yet there is a concern for increase in operative cost. This study aim to review and compare the short-term results of laparoscopic TME (L-TME) and robotic-assisted TME (R-TME) in a single centre. Methods: This study is based on a prospectively collected database of patients with mid to low rectal cancer undergoing either L-TME or R-TME from January 2006 to September 2014. Data on patient demographics, intraoperative parameters and short-term outcome were collected. All patients with cancer of rectum within 12cm from the anal verge (AV) were included. Those with multi-organ resections were excluded. Results: During this period, there were a total of 137 and 164 consecutive patients undergoing L-TME and R-TME respectively. The mean age was 66.4±13.2 and 65.7±10.9 years for L-TME and R-TME. The mean tumour distance from AV was 69.3±29.9 and 68.0±29.9mm for L-TME and R-TME. There was no difference between the demographics in terms of sex, American Society of Anesthesiologist score, preoperative radiation and tumour staging. The mean operating time for R-TME was significantly longer, 271.5±66.5 vs 229.2±60.7 min, p=0.00. Difference in terms of blood loss was not significant. Conversion rate of L-TME and R-TME was 2.9% and 1.8%, p=0.71. Sphincter-saving procedure was done in 91.2% of L-TME and 92.1% of R-TME. Mean hospital stay was 8.5±9.4 and 8.0±7.4 days for L-TME and R-TME, p=0.60. Mean distal margin of L-TME and R-TME was 33.4±15.2mm and 31.3±15.9mm, p-=0.25. Positive circumferential radial margin was found in 8.0% of L-TME and 4.9% of R-TME, p=0.34. Complications rate of L-TME and R-TME was 17.5% and 14.0%. In particular, there was a significantly higher percentage of postoperative urinary retentions in L-TME 11.7% vs 4.3%, p=0.02, RR 2.74, 95% CI 1.16–6.46. 30 day mortally L-TME and R-TME was 1.5% and 1.2%, p=0.61. Conclusion: In the treatment of mid to low rectal cancer, robotic-assisted and laparoscopic total mesorectal excision has comparable short–term outcome. Robotic-assisted approach, however, might offer better functional outcome as a result of autonomic nerve preservation.-
dc.languageeng-
dc.relation.ispartofAnnual Scientific Meeting of the American Society of Colon and Rectal Surgeons, ASCRS 2015-
dc.titleComparison of short-term outcome between robotic-assisted and laparoscopic total mesorectal excision for mid to low rectal cancer-
dc.typeConference_Paper-
dc.identifier.emailFoo, C: ccfoo@hku.hk-
dc.identifier.emailLaw, W: lawwl@hkucc.hku.hk-
dc.identifier.authorityFoo, C=rp01899-
dc.identifier.authorityLaw, W=rp00436-
dc.identifier.hkuros246065-

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