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Clinical, oncological, and functional outcomes of Da Vinci (Xi)–assisted versus conventional laparoscopic resection for rectal cancer: a prospective, controlled cohort study of 51 consecutive cases

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Despite the increasing use of telemanipulators in colorectal surgery, an additional benefit in terms of improved perioperative results is not proven. The aim of the study was to compare clinical, oncological, and functional results of Da Vinci (Xi)–assisted versus conventional laparoscopic (low) anterior resection for rectal cancer.

Methods

Monocenter, prospective, controlled cohort study with a 12-month follow-up of bladder and sexual function using the validated questionnaires International Prostate Symptom Score, International Index of Erectile Function, and Female Sexual Function Index.

Results

Fifty-one patients were included (18, Da Vinci (Xi) assisted; 33, conventional laparoscopy). Conversion to an open approach was more common in the Da Vinci cohort (p = 0.012). In addition, surgery and resumption of a normal diet took longer in the robotic group (p = 0.005; p = 0.042). Surgical morbidity and oncological quality did not differ. There was no difference in most functional domains, except for worsened ability to orgasm (p = 0.047) and sexual satisfaction (p = 0.034) in women after conventional laparoscopy. Moreover, we found a higher rate of improved bladder function in the conventional laparoscopy group (p = 0.023) and less painful sexual intercourse among women in the robot-assisted group (p = 0.049).

Conclusion

In contrast to the ROLARR trial, a higher conversion rate was found in the robotic cohort, which may in part be explained by a learning curve effect. Nevertheless, the Da Vinci–assisted approach showed favorable results regarding sexual function.

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Authorship and contributions

J. Hardt, C. Galata, G. Vassilev, P. Kienle, C. Reißfelder: conceived of the study

J. Hardt, F. Haas, S. Büttner: acquired and analyzed the data

All authors interpreted the data, revised the article for important intellectual content, and gave final approval of the version to be published.

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Author notes

  1. C. Galata and G. Vassilev contributed equally to this work.

Authors and Affiliations

  1. Department of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

    C. Galata, G. Vassilev, F. Haas, C. Reißfelder & Julia Hardt

  2. Department of Surgery, Theresienkrankenhaus Mannheim, Mannheim, Germany

    P. Kienle

  3. Department of Medical Statistics and Biomathematics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

    S. Büttner

  4. Department of Surgery, University Hospital Mannheim, Faculty of the University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany

    Julia Hardt

Authors
  1. C. Galata
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  2. G. Vassilev
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  3. F. Haas
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  4. P. Kienle
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  6. C. Reißfelder
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  7. Julia Hardt
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Corresponding author

Correspondence to Julia Hardt.

Ethics declarations

The trial received institutional ethical approval by the ethics committee of the Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany (2015-636 N-MA). The study was performed according to the Declaration of Helsinki. All participants provided written informed consent.

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The authors declare that they have no conflict of interest.

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Galata, C., Vassilev, G., Haas, F. et al. Clinical, oncological, and functional outcomes of Da Vinci (Xi)–assisted versus conventional laparoscopic resection for rectal cancer: a prospective, controlled cohort study of 51 consecutive cases. Int J Colorectal Dis 34, 1907–1914 (2019). https://doi.org/10.1007/s00384-019-03397-w

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  • DOI: https://doi.org/10.1007/s00384-019-03397-w

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