Long-Term Outcomes of Robotic Versus Laparoscopic Total Mesorectal Excisions: A Propensity-Score Matched Cohort study of 5-year survival outcomes
Objective:. To compare long-term outcomes between laparoscopic and robotic total mesorectal excisions (TMEs) for rectal cancer in a tertiary center. Background:. Laparoscopic rectal cancer surgery has comparable long-term outcomes to the open approach, with several advantages in short-term outcomes....
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Health
2024-06-01
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| Series: | Annals of Surgery Open |
| Online Access: | http://journals.lww.com/10.1097/AS9.0000000000000404 |
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| author | Rauand Duhoky, MsC Marieke L. W. Rutgers, MsC Thijs A. Burghgraef, MsC Samuel Stefan, MD Shamsul Masum, PhD Guglielmo N. Piozzi, MD Filippos Sagias, MD Jim S. Khan, MD, PhD |
| author_facet | Rauand Duhoky, MsC Marieke L. W. Rutgers, MsC Thijs A. Burghgraef, MsC Samuel Stefan, MD Shamsul Masum, PhD Guglielmo N. Piozzi, MD Filippos Sagias, MD Jim S. Khan, MD, PhD |
| author_sort | Rauand Duhoky, MsC |
| collection | DOAJ |
| description | Objective:. To compare long-term outcomes between laparoscopic and robotic total mesorectal excisions (TMEs) for rectal cancer in a tertiary center.
Background:. Laparoscopic rectal cancer surgery has comparable long-term outcomes to the open approach, with several advantages in short-term outcomes. However, it has significant technical limitations, which the robotic approach aims to overcome.
Methods:. We included patients undergoing laparoscopic and robotic TME surgery between 2013 and 2021. The groups were compared after propensity-score matching. The primary outcome was 5-year overall survival (OS). Secondary outcomes were local recurrence (LR), distant recurrence (DR), disease-free survival (DFS), and short-term surgical and patient-related outcomes.
Results:. A total of 594 patients were included, and after propensity-score matching 215 patients remained in each group. There was a significant difference in 5-year OS (72.4% for laparoscopy vs 81.7% for robotic, P = 0.029), but no difference in 5-year LR (4.7% vs 5.2%, P = 0.850), DR (16.9% vs 13.5%, P = 0.390), or DFS (63.9% vs 74.4%, P = 0.086). The robotic group had significantly less conversion (3.7% vs 0.5%, P = 0.046), shorter length of stay [7.0 (6.0–13.0) vs 6.0 (4.0–8.0), P < 0.001), and less postoperative complications (63.5% vs 50.7%, P = 0.010).
Conclusions:. This study shows a correlation between higher 5-year OS and comparable long-term oncological outcomes for robotic TME surgery compared to the laparoscopic approach. Furthermore, lower conversion rates, a shorter length of stay, and a less minor postoperative complications were observed. Robotic rectal cancer surgery is a safe and favorable alternative to the traditional approaches. |
| format | Article |
| id | doaj-art-6b04eca09e3b4d8593525fb0742885ae |
| institution | Kabale University |
| issn | 2691-3593 |
| language | English |
| publishDate | 2024-06-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Annals of Surgery Open |
| spelling | doaj-art-6b04eca09e3b4d8593525fb0742885ae2025-01-24T09:18:39ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932024-06-0152e40410.1097/AS9.0000000000000404202406000-00006Long-Term Outcomes of Robotic Versus Laparoscopic Total Mesorectal Excisions: A Propensity-Score Matched Cohort study of 5-year survival outcomesRauand Duhoky, MsC0Marieke L. W. Rutgers, MsC1Thijs A. Burghgraef, MsC2Samuel Stefan, MD3Shamsul Masum, PhD4Guglielmo N. Piozzi, MD5Filippos Sagias, MD6Jim S. Khan, MD, PhD7From the * Department of Colorectal Surgery, Portsmouth Hospitals University NHS Trust, Portsmouth, UKFrom the * Department of Colorectal Surgery, Portsmouth Hospitals University NHS Trust, Portsmouth, UK‡ Department of Surgery, University Medical Centre Utrecht, Utrecht, the NetherlandsFrom the * Department of Colorectal Surgery, Portsmouth Hospitals University NHS Trust, Portsmouth, UK§ University of Portsmouth, Portsmouth, UKFrom the * Department of Colorectal Surgery, Portsmouth Hospitals University NHS Trust, Portsmouth, UKFrom the * Department of Colorectal Surgery, Portsmouth Hospitals University NHS Trust, Portsmouth, UKFrom the * Department of Colorectal Surgery, Portsmouth Hospitals University NHS Trust, Portsmouth, UKObjective:. To compare long-term outcomes between laparoscopic and robotic total mesorectal excisions (TMEs) for rectal cancer in a tertiary center. Background:. Laparoscopic rectal cancer surgery has comparable long-term outcomes to the open approach, with several advantages in short-term outcomes. However, it has significant technical limitations, which the robotic approach aims to overcome. Methods:. We included patients undergoing laparoscopic and robotic TME surgery between 2013 and 2021. The groups were compared after propensity-score matching. The primary outcome was 5-year overall survival (OS). Secondary outcomes were local recurrence (LR), distant recurrence (DR), disease-free survival (DFS), and short-term surgical and patient-related outcomes. Results:. A total of 594 patients were included, and after propensity-score matching 215 patients remained in each group. There was a significant difference in 5-year OS (72.4% for laparoscopy vs 81.7% for robotic, P = 0.029), but no difference in 5-year LR (4.7% vs 5.2%, P = 0.850), DR (16.9% vs 13.5%, P = 0.390), or DFS (63.9% vs 74.4%, P = 0.086). The robotic group had significantly less conversion (3.7% vs 0.5%, P = 0.046), shorter length of stay [7.0 (6.0–13.0) vs 6.0 (4.0–8.0), P < 0.001), and less postoperative complications (63.5% vs 50.7%, P = 0.010). Conclusions:. This study shows a correlation between higher 5-year OS and comparable long-term oncological outcomes for robotic TME surgery compared to the laparoscopic approach. Furthermore, lower conversion rates, a shorter length of stay, and a less minor postoperative complications were observed. Robotic rectal cancer surgery is a safe and favorable alternative to the traditional approaches.http://journals.lww.com/10.1097/AS9.0000000000000404 |
| spellingShingle | Rauand Duhoky, MsC Marieke L. W. Rutgers, MsC Thijs A. Burghgraef, MsC Samuel Stefan, MD Shamsul Masum, PhD Guglielmo N. Piozzi, MD Filippos Sagias, MD Jim S. Khan, MD, PhD Long-Term Outcomes of Robotic Versus Laparoscopic Total Mesorectal Excisions: A Propensity-Score Matched Cohort study of 5-year survival outcomes Annals of Surgery Open |
| title | Long-Term Outcomes of Robotic Versus Laparoscopic Total Mesorectal Excisions: A Propensity-Score Matched Cohort study of 5-year survival outcomes |
| title_full | Long-Term Outcomes of Robotic Versus Laparoscopic Total Mesorectal Excisions: A Propensity-Score Matched Cohort study of 5-year survival outcomes |
| title_fullStr | Long-Term Outcomes of Robotic Versus Laparoscopic Total Mesorectal Excisions: A Propensity-Score Matched Cohort study of 5-year survival outcomes |
| title_full_unstemmed | Long-Term Outcomes of Robotic Versus Laparoscopic Total Mesorectal Excisions: A Propensity-Score Matched Cohort study of 5-year survival outcomes |
| title_short | Long-Term Outcomes of Robotic Versus Laparoscopic Total Mesorectal Excisions: A Propensity-Score Matched Cohort study of 5-year survival outcomes |
| title_sort | long term outcomes of robotic versus laparoscopic total mesorectal excisions a propensity score matched cohort study of 5 year survival outcomes |
| url | http://journals.lww.com/10.1097/AS9.0000000000000404 |
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