Robotic rectal cancer surgery improves treatment outcomes

This study investigated the outcomes of patients with colorectal cancer who underwent robotic surgery. Researchers suggested that the da Vinci robotic system improved the surgery outcomes of these patients. 

Rectal cancer accounts for around 30% of all colorectal cancers. Surgery is the standard method of treatment and it significantly improves the outcomes of these patients. However, the risk of recurrence (when cancer comes back) is still high. Chemotherapy before surgery might reduce the risk of recurrence which made this the current recommended method to treat advanced rectal cancer.

Prior studies suggested that laparoscopic (keyhole) surgery improves treatment outcomes and recovery. It consists of inserting a tube with a camera through a small opening to remove the tumor. The robotic system (da Vinci system) has been shown to improve laparoscopic surgery performance in narrow spaces.  

The ligation of the inferior mesenteric artery (IMA) during surgery reduces blood flow in the bowel. However, it increases the chance of anastomosis leakage (leakage of body fluid through the surgical wound). Prior studies suggested that robotic surgery with IMA resulted in low anastomosis leakage. The effectiveness of robotic rectal cancer surgery with the ligation of IMA is still not clear.

This study included information about 113 patietns with rectal cancer. All participants underwent surgery with ligation of IMA using the robotic da Vinci system. Overall survival (OS; time from treatment to death by any cause), disease-free survival (DFS; time from treatment to disease progression), and complications were assessed. Patients were followed up for an average of 49.1 months.

After surgery, the anal sphincter preservation rate was 96.3%. The average number of collected lymph nodes was 12. Complete surgery (with no remaining tumor cells) was performed in 108 (95.6%) of the patients.

The overall complication rate was 17.7%. However, most complications after surgery were mild. 5-year OS was 86.1% and 3-year DFS was 79.6%.

This study concluded that the da Vinci robotic system improves the ligation of IMA and rectal cancer surgery outcomes. 

This study included a limited number of participants, as well as a short follow-up period. Further studies with bigger populations and extended follow-up are necessary.