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Surgical outcomes of robotic, laparoscopic, and open low anterior resection after preoperative chemoradiotherapy for patients with advanced lower rectal cancer

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Abstract

Purpose

We investigated the surgical outcomes of robotic low anterior resection (LAR) for lower rectal cancer after preoperative chemoradiotherapy (pCRT).

Methods

A total of 175 patients with lower rectal cancer who underwent LAR after pCRT between 2005 and 2020 were stratified into open (OS, n = 65), laparoscopic (LS, n = 64), and robotic surgery (RS, n = 46) groups. We compared the clinical, surgical, and pathological results among the three groups.

Results

The RS and LS groups had less blood loss than the OS group (p < 0.0001). The operating time in the RS group was longer than in the LS and OS groups (p < 0.0001). The RS group had a significantly longer mean distal margin than the LS and OS groups (25.4 mm vs. 20.7 mm and 20.3 mm, respectively; p = 0.026). There was no significant difference in the postoperative complication rate among the groups. The local recurrence rate in the RS group was comparable to those in the LS and OS groups.

Conclusion

Robotic LAR after pCRT was performed safely for patients with advanced lower rectal cancer. It provided a longer distal margin and equivalent local control rates.

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Acknowledgements

This research is supported by Grants-in-Aid for Scientific Research (C: grant number; 18K07194, C: grant number; 19K09114, C: grant number; 19K09115, C: grant number; 20K09051, Challenging Research [Exploratory]: grant number; 20K21626, B: grant number; 21H02778) from Japan Society for the promotion of Science. This research is supported by the Project for Cancer Research and Therapeutic Evolution (P-CREATE), grant number: JP 19cm0106502 from the Japan Agency for Medical Research and Development (AMED).

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Authors and Affiliations

  1. Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan

    Sukchol Lim, Yuzo Nagai, Hiroaki Nozawa, Kazushige Kawai, Kazuhito Sasaki, Koji Murono, Shigenobu Emoto, Yuichiro Yokoyama, Tsuyoshi Ozawa, Shinya Abe, Hiroyuki Anzai, Hirofumi Sonoda & Soichiro Ishihara

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  1. Sukchol Lim
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Contributions

All authors (SL, YN, HN, KK, KS, KM, SE, YY, TO, SA, HA, HS, SI) contributed substantially to conception and design, acquisition of data, and analysis and interpretation of data. The authors also drafted the article or critically revised it for important intellectual content and gave final approval of the version to be published.

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Correspondence to Sukchol Lim.

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The authors declare that they have no conflict of interest.

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Written informed consent was obtained from all participants in the study.

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The participants consented to the journal submission.

Ethics approval

This study was approved by the Ethics Committees of the University of Tokyo (No. 3252-(12)).

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Lim, S., Nagai, Y., Nozawa, H. et al. Surgical outcomes of robotic, laparoscopic, and open low anterior resection after preoperative chemoradiotherapy for patients with advanced lower rectal cancer. Surg Today 53, 109–115 (2023). https://doi.org/10.1007/s00595-022-02537-0

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  • DOI: https://doi.org/10.1007/s00595-022-02537-0

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