Robotic- vs laparoscopic-assisted proctectomy: short-term efficacy and long-term outcomes at a colorectal center in China

Abstract

Abstract Background The latest statistics indicate a gradual increase in the incidence of rectal cancer, with approximately 60–70% of patients being diagnosed at an advanced stage. Presently, robot-assisted surgery is extensively performed in numerous countries worldwide. To evaluate the short-term efficacy and long-term outcomes of Da Vinci robot in patients with middle and low rectal cancer. Methods A case series analysis was conducted on 235 patients with middle and low rectal cancer who were admitted to the First Department of Gastrointestinal Surgery, the Second Affiliated Hospital of Dalian Medical University from January 2020 to March 2023. They were divided into Da Vinci robot-assisted proctectomy group and 3D laparoscopic-assisted proctectomy group, with 125 patients in robot-assisted proctectomy group and 110 patients in 3D laparoscopic-assisted proctectomy group. Results Baseline data, perioperative outcomes, morbidity, pathological data, as well as 3-year overall survival and disease-free survival rates were analyzed and compared between the two groups. Intraoperative blood loss was significantly lower in the robot-assisted proctectomy group while hospitalization cost was higher (P < 0.05). No significant differences were observed in exhaust time, catheter removal time, indentation catheter time, postoperative complications or number of lymph nodes dissection between the two groups (P > 0.05). After a follow-up period of 40 months, there were no significant differences in local recurrence, distant metastasis, sexual dysfunction, urinary dysfunction or disease-free survival and overall survival rates (P > 0.05). Conclusion Robot-assisted proctectomy is a safe and feasible treatment option for rectal cancer with comparable short-term oncological results.