Rectal cancer: short- and long-term outcomes of robotic assisted laparoscopic surgery

This article investigated the short- and long-term outcomes of patients with rectal cancer who underwent robotic-assisted laparoscopic surgery (RALS).

The authors concluded that RALS is beneficial and has good short- and long-term outcomes. 

Conventional laparoscopic surgery (CLS; involves small cuts and a camera inserted into the abdomen to perform minimally invasive surgery) and open surgery (OS) are the current standard treatments for patients with rectal cancer. CLS has shown better short-term outcomes compared with open surgery. However, it may be associated with an incomplete removal of the tumor due to inflexible instruments and inadequate visualization. This can be associated with cancer recurrence. 

An alternative treatment method to CLS is RALS. This method uses free-moving instruments and high-quality imaging giving better visualization. The long-term outcomes of RALS are still under investigation.

This study involved 511 patients with rectal cancer who underwent RALS. Short-term outcomes such as complication during surgery and 30 days after the surgery were evaluated. 204 of these patients were followed up for an average of 43.6 months. Long-term outcomes such as relapse-free survival (RFS; survival after treatment without any signs of cancer) and cancer-specific survival (CSS; the percentage of patients who have not died from cancer)

7.6% of 551 patients underwent chemotherapy and radiation before surgery. No patients from the initial group needed a blood transfusion or conversion from RALS to open surgery. The most common severe side effects of surgery included urinary retention, infections, small bowel obstruction in 18 patients (3.3%).

In the long-term group, the 5-year CSS rate was 100% for patients with stages I-III and not reached for those with stage IV cancer. The 5-year RFS rate was 93.6% for patients with stage I, 75% for stage II, 77.6% for stage III and not reached for stage IV. 0.5% of all patients experienced a cancer recurrence at the place where it started (local recurrence). 

The authors concluded that RALS is a safe and effective treatment and has good short- and long-term outcomes for patients with rectal cancer. 

This study was based on medical records from a single institution. Larger studies are needed from more centers to confirm results. 

If you have concerns regarding surgery for rectal cancer, talk to your doctor to see if you are eligible for RALS.