Is robotic surgery for rectal cancer superior to conventional surgery, finds Study

China: In an intriguing robotic technology study, it was discovered that robotic surgery has no association with improved survival compared to laparoscopic surgery for rectal cancer; however, robotic surgery is a safe and feasible surgical procedure, particularly in some sophisticated cases with lower tumor locations.

Robotic surgery has emerged as a novel method for overcoming the technological constraints of traditional surgery. The goal of this study is to evaluate the oncologic outcomes of individuals with rectal cancer who received robotic vs laparoscopic surgery. This study was conducted by Xiong Lei and the team. The result and interpretations of this study were published in BMC Surgery on 28th September 2021.

Data from patients diagnosed with rectal cancer between March 2011 and December 2018 were collected for outcome analysis at Nanchang University's First Affiliated Hospital. All patients were divided into two groups: the robotic group (patients undergoing robotic surgery, n = 314) and the laparoscopic group (patients undergoing laparoscopic surgery, n = 220). Survival outcomes were the primary objective. The general circumstances of the surgery, postoperative complications, and pathological features were the secondary endpoints.

In this retrospective comparative cohort research, there was no difference in survival between patients with rectal cancer who underwent robotic surgery and those who underwent laparoscopic surgery. However, there was a reduction in postoperative complications, operating time, hospital stay, and time to first gas passage, indicating that robotic surgery has a short-term advantage. Furthermore, researchers discovered that patients who had robotic surgery had a lower tumour location and advanced clinical stage than those who had laparoscopic surgery. There was no significant difference in any postoperative short- or long-term problems, although the incidence of urine retention was considerably lower in individuals who received robotic surgery than those who underwent laparoscopic surgery. There were four patients (4/314) with positive circumferential resection margin (CRM) in the robot group, and two patients with positive CRMs experienced local recurrence. However, there were no occurrences of positive CRM in the laparoscopy group, and local recurrence occurred in 12 cases (12/224) of negative CRM.

In conclusion, this single-center retrospective comparative cohort research found that robot-assisted rectal cancer resection had a short-term benefit but was not superior to traditional laparoscopy in terms of survival.

Reference:

Lei, X., Yang, L., Huang, Z. et al. No beneficial effect on survival but a decrease in postoperative complications in patients with rectal cancer undergoing robotic surgery: a retrospective cohort study. BMC Surg 21, 355 (2021). https://doi.org/10.1186/s12893-021-01309-w