Robotic versus laparoscopic anterior resection of sigmoid colon cancer: comparative study of long-term oncologic outcomes

机器人辅助与腹腔镜乙状结肠癌前切除术:长期肿瘤学疗效的比较研究

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Abstract

BACKGROUND: Robotically assisted colon resection is a new type of surgery for colon cancer. However, the evidence is inadequate for the general adaptation of robotic colon surgery. This study aimed to show the oncologic and perioperative clinical results of robotically assisted anterior resection (R-AR) compared with those of laparoscopically assisted anterior resection (L-AR) for sigmoid colon cancer. METHODS: A total of 180 patients (sigmoid colon cancer stages 1-3) were assigned to receive either R-AR (n = 34) or L-AR (n = 146) between April 2006 and September 2008. Patient characteristics, perioperative clinical results, and long-term oncologic outcomes were compared between the two groups. RESULTS: The patient characteristics did not differ significantly between the two groups. The mean operation time was 217.6 ± 70.7 min for L-AR versus 252.5 ± 94.9 min for R-AR (p = 0.016). The total postoperative complication rate was 10.3 % for R-AR versus 5.9 % for L-AR (p = 0.281). The 3-year overall survival rate for all the patients was 93.4 % for L-AR versus 92.1 % for R-AR (p = 0.723). The 3-year overall survival rate was 100 % for both L-AR and R-AR in stage 1, 95.5 % for L-AR versus 100 % for R-AR (p = 0.386) in stage 2, and 88.4 % for L-AR versus 72.9 % (p = 0.881) for R-AR in stage 3. CONCLUSION: In this study, R-AR showed safety and feasibility in terms of perioperative clinical and long-term oncologic outcomes. However, the advanced technologies of R-AR did not translate into better long-term oncologic outcomes compared with L-AR.

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