Article Sidebar
Views PDF: 26
ROBOTIC SURGERY FOR RECTAL CANCER AFTER PREOPERATIVE CHEMORADIOTHERAPY AT BINH DAN HOSPITAL: SHORT-TERM OUTCOMES
Main Article Content
Abstract
Introduction: Rectal cancer is a common malignant disease in Vietnam and patients who often come to the hospital at a late stage. Treatment of rectal cancer is multimodal (surgery - radiotherapy and chemotherapy) but surgery is still the mainstay of treatment. Robotic total mesorectal excision is a novel approach for the treatment of rectal cancer, that has been shown in previous studies to be safe and effective [1], [2]. Our aim was to evaluate the safety and the short-term outcomes of robotic surgery for rectal cancer after preoperative chemoradiotherapy. Materials and methods: Prospective case series study: 45 rectal cancer cases after preoperative chemoradiotherapy were operated by robotic da Vinci Surgical System (Si version) and anastomosis in (02 years) from December 2020 to December 2022 at Binh Dan hospital. Results: Men/Women ratio: 1,25. Average age: 58 yrs (29-79). The conversion rate was 0%. The median console time was 110 minutes, total operative time was 210 minutes. The median number of harvested lymph nodes was 15,3 ± 3,8, metastatic lymph nodes was 2,3 ± 1,7. Bood loss was 35,3 ± 14,8 ml, circumferential resection margin (CRM +) was positive 2,2%, Total mesorectal excision (TME) quality was complete 95,6%. Post-operative pathology staging: stage I: 5 cases (11,1%), stage II: 30 cases (66,7%), stage III: 10 cases (22,2%). Complications: Intra-operative, there was 1 case of bleeding. Post-operative, there were: 4 cases of wound infection, 1 case of urine retention, 2 cases of anastomotic leak that was successful internal treatment, 1 case of ileostomy stenosis and 1 case of ileostomy prolapse. Average length of stay after the operation is 7,9 days (6-15). No port-site recurrence occurred in any patient. The mean follow-up of 9,3 months, range: 5–17 months. Conclusion: The use of robotic surgery for rectal cancer after preoperative chemoradiotherapy is a safe and feasible procedure in oncology. Robotic surgery is convenient in the tight space of the pelvis, especially in cases after preoperative chemoradiotherapy.
Article Details
Keywords
: rectal cancer, robotic surgery, preoperative chemoradiotherapy, low anterior resection (LAR).
References
2. Jayne D., Pigazzi A., Marshall H., et al (2017). Effect of robotic-assisted vs conventional laparoscopic surgery on risk of conversion to open laparotomy among patients undergoing resection for rectal cancer the rolarr randomized clinical trial. JAMA - J Am Med Assoc, 318(16), pp.1569–1580.
3. Nasir M, Ahmed J et al (2016). Learning Curves in Robotic Rectal Cancer Surgery: A literature Review. J Min im Invasive Surg Sci, 5(4): e41196
4. Pigazzi A. et al (2010). Multicentric Study on Robotic Tumor-Specific Mesorectal Excision for the Treatment of Rectal Cancer. Ann Surg Oncol, 17(6), pp.1614-1620.
5. Ramos J.R., Miranda A.D., Torres W. et al (2014). Four-arm single docking full robotic surgery for low rectal cancer: techniques and post-operative outcomes. J Coloproctology, 34(2), pp.87–94.
6. Tzu-Chun Chen, Jin-Tung Liang (2022). Robotic versus laparoscopic surgery for rectal cancer after neoadjuvant chemoradiotherapy: A propensity-score matching analysis. Journal of the Formosan Medical Association 12, pp.1532-1540.
7. Yong Sok Kim et al (2015). Robotic Versus Laparoscopic Surgery for Rectal Cancer after Preoperative Chemoradiotherapy: Case-Matched Study of Short-Term Outcomes. Cancer Res Treat, pp.1-7.
8. Wenju Chang et al (2020). Short‑term and long‑term outcomes of robotic rectal surgery—from the real word data of 1145 consecutive cases in China. Surgical Endoscopy, (34), pp.4079–4088.