Robot-assisted surgery for rectal cancer in patients after neoadjuvant chemoradiotherapy Immediate results

Abstract

Introduction. The benefits of robotic surgery for rectal cancer remain controversial. Only a few studies have evaluated the safety and feasibility of robot-assisted surgery after neoadjuvant chemoradiotherapy.Aim. Our study aimed to compare the short-term outcomes of robotic and traditional laparoscopic surgery after neoadjuvant chemoradiotherapy for rectal cancer.Materials and methods. This retrospective study was based on the analysis of 210 medical records of patients with rectal tumors who underwent robot-assisted and laparoscopic-assisted surgeries after neoadjuvant chemoradiotherapy from 2015 to 2021.Results. There was no significant difference in short-term outcomes such as operation time, conversion rate, anastomotic leakage, and quality of circular resection margin. However, a significant difference was noted in the quality of total mesorectal excision. Grade 3 quality in the R group was 93.9 %, while in the L group it was 74.07 % (Odds Ratio (OR) 2.335; 95 % Confidence Interval (CI) 1.107–4.925). A statistically significant difference was also found in the rate of performing sphincter-preserving procedures, with 12.2 % in the R group and 50 % in the L group (OR 0.139; 95 % CI 0.066–0.293).Conclusion. The advantages of the robotic surgical system in the surgical treatment of rectal cancer in patients after neoadjuvant chemoradiotherapy improve clinical outcomes, primarily reflected in the rate of sphincter-preserving operations. Additionally, it provides a trend towards achieving more oncologically adequate tumor removal compared to laparoscopic procedures.