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Advantages of robotic abdominoperineal resection compared with laparoscopic surgery: a single-center retrospective study

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Abstract

Purpose

Although robotic surgery for rectal cancer can overcome the shortcomings of laparoscopic surgery, studies focusing on abdominoperineal resection are limited. The aim of this study was to compare the operative outcomes between robotic and laparoscopic abdominoperineal resection.

Methods

This retrospective cohort study was conducted from April 2010 to March 2020. Patients with rectal cancer who underwent robotic or laparoscopic abdominoperineal resection without lateral lymph node dissection were enrolled. The perioperative and oncological outcomes were compared.

Results

We evaluated 33 and 20 patients in the robotic and laparoscopic groups, respectively. The median operative time and blood loss were comparable between the two groups. No significant differences in the overall complication rates were noted, whereas the rates of urinary dysfunction (3% vs. 26%, p = 0.02) and perineal wound infection (9% vs. 35%, p = 0.03) in the robotic group were significantly lower in comparison to the laparoscopic group. The median postoperative hospital stay was significantly shorter in the robotic group (8 days vs. 11 days, p < 0.01). The positive resection margin rates were comparable between the two groups.

Conclusion

Robotic abdominoperineal resection demonstrated better short-term outcomes than laparoscopic surgery, suggesting that it could be a useful approach.

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Acknowledgements

We wish to thank Takanori Kawabata, a biostatistician, for providing advice on the statistical analyses. We are grateful to Reiko Suzuki for her narration of Online Resource 1.

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Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan

    Shunsuke Kasai, Hiroyasu Kagawa, Akio Shiomi, Hitoshi Hino, Shoichi Manabe, Yusuke Yamaoka, Shunichiro Kato, Marie Hanaoka & Yusuke Kinugasa

  2. Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan

    Shunsuke Kasai, Marie Hanaoka & Yusuke Kinugasa

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  1. Shunsuke Kasai
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Correspondence to Hiroyasu Kagawa.

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Supplementary Information

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Online Resource 1: Dissection of the levator ani muscle in robotic abdominoperineal resection Robotic surgery typically enables dissection of the levator ani muscle in abdominoperineal resection. Reaching the ischiorectal fossa as deeply as possible in the abdominopelvic procedure allows better access for perineal dissection (MPG 5434 KB)

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Kasai, S., Kagawa, H., Shiomi, A. et al. Advantages of robotic abdominoperineal resection compared with laparoscopic surgery: a single-center retrospective study. Surg Today 52, 643–651 (2022). https://doi.org/10.1007/s00595-021-02359-6

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  • DOI: https://doi.org/10.1007/s00595-021-02359-6

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