Application of da Vinci Robotic Surgical System in Radical Resection of Rectal Cancer: A Report of 456 Cases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 TANGBo , ZENGDong-zhu , ZHANGChao , LEIXiao , GANLu , CHENHua , LUOHua-xing , LIChuan ,  YUPei-wu

General Surgery Center of PLA, Minimally Invasive Center of Gastrointestinal Surgery, Southwest Hospital of The Third Military Medical University, Chongqing 400038, China;

Corresponding author：

YUPei-wu, Email: yupeiwu@sina.com

Keywords：

da Vinci robotic surgical system; Radical resection of rectal cancer; Rectal cancer; Efficacy

DOI：

10.7507/1007-9424.20160363

Video：

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Objective To explore the efficacy of da Vinci robotic surgical system-assisted radical resection of rectal cancer. Methods The clinical data of 456 patients who received radical resection of rectal cancer by the da Vinci robotic surgical system at the Southwest Hospital from March 2010 to March 2016 were retrospectively analyzed. Operative time, operative blood loss, number of harvested lymph nodes, hospital stay, and morbidity were evaluated. Results da Vinci robotic surgical system-assisted radical resection of rectal cancer were successfully carried out in 445 patients, and other 11 patients were converted to open surgery (2.4%). Of 456 patients, 322 patients underwent anterior resection of rectum procedure (70.6%), 126 patients underwent abdominoperineal excision procedure (27.6%), 8 patients underwent Hartmann procedure (1.8%). The mean operative time was (192±60) min, the mean operative blood loss was (110±93) mL, the mean number of harvested lymph nodes were 19±6, the mean length between distal resection margin and tumor were (3.5±1.8) cm, the mean time for patients taking normal activity was (2.9±1.5) d, the mean time of passage of the first flatus was (2.7±1.7) d, the mean hospital stay was (7.1±1.6) d. Surgical complications occurred in 40 patients (8.8%), and all the patients were recovery before leaving hospital. The mean follow-up time was 29.1-month (3-75 months). There were 70 patients suffered from occurrence or metastasis (16.2%), and 60 patients died (13.9%). Conclusion da Vinci robotic surgical system-assisted radical resection for rectal cancer is a feasible and safe surgical procedure with the minimal trauma, fast recovery, and satisfactory clinical efficacy.

Citation： TANGBo, ZENGDong-zhu, ZHANGChao, LEIXiao, GANLu, CHENHua, LUOHua-xing, LIChuan, YUPei-wu. Application of da Vinci Robotic Surgical System in Radical Resection of Rectal Cancer: A Report of 456 Cases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(12): 1419-1423. doi: 10.7507/1007-9424.20160363 Copy

1.	Weber PA, Merola S, Wasielewski A, et al. Telerobotic-assisted laparoscopic right and sigmoid colectomies for benign disease. Dis Colon Rectum, 2002, 45(12):1689-1696.
2.	Kakeji Y, Konishi K, Ieiri S, et al. Robotic laparoscopic distal gastre-ctomy:a comparison of the da Vinci and Zeus systems. Int J Med Robot, 2006, 2(4):299-304.
3.	Patriti A, Ceccarelli G, Bellochi R, et al. Robot-assisted laparoscopic total and partial gastric resection with D2 lymph node dissection for adenocarcinoma. Surg Endosc, 2008, 22(12):2753-2760.
4.	余佩武, 唐波, 曾冬竹, 等.达芬奇机器人胃癌根治术41例.中华胃肠外科杂志, 2012, 15(2):121-124.
5.	刘驰, 唐波, 郝迎学, 等.达芬奇机器人与腹腔镜胃癌手术近期疗效的对照研究.第三军医大学学报, 2013, 35(11):1164-1166.
6.	Huang KH, Lan YT, Fang WL, et al. Comparison of the operative outcomes and learning curves between laparoscopic and robotic gastrectomy for gastric cancer. PLoS One, 2014, 9(10):e111499.
7.	Baik SH, Kang CM, Lee WJ, et al. Robotic total mesorectal excision for the treatment of rectal cancer. J Robot Surg, 2007, 1(1):99-102.
8.	Gómez Ruiz M, Alonso Martin J, Cagigas Fernández C, et al. Short-and mid-term outcomes of robotic-assisted total mesorectal excision for the treatment of rectal cancer. Our experience after 198 consecutive cases. Eur J Surg Oncol, 2016, 42(6):848-854.
9.	Ghezzi TL, Luca F, Valvo M, et al. Robotic versus open total mesorectal excision for rectal cancer:comparative study of short and long-term outcomes. Eur J Surg Oncol, 2014, 40(9):1072-1079.
10.	Serin KR, Gultekin FA, Batman B, et al. Robotic versus laparoscopic surgery for mid or low rectal cancer in male patients after neoadjuvant chemoradiation therapy:comparison of short-term outcomes. J Robot Surg, 2015, 9(3):187-194.
11.	Luca F, Valvo M, Ghezzi TL, et al. Impact of robotic surgery on sexual and urinary functions after fully robotic nerve-sparing total mesorectal excision for rectal cancer. Ann Surg, 2013, 257(4):672-678.
12.	Baek SK, Carmichael JC, Pigazzi A. Robotic surgery:colon and rectum. Cancer J, 2013, 19(2):140-146.
13.	Baek JH, McKenzie S, Garcia-Aguilar J, et al. Oncologic outcomes of robotic-assisted total mesorectal excision for the treatment of rectal cancer. Ann Surg, 2010, 251(5):882-886.
14.	Park EJ, Cho MS, Baek SJ, et al. Long-term oncologic outcomes of robotic low anterior resection for rectal cancer:a comparative study with laparoscopic surgery. Ann Surg, 2015, 261(1):129-137.
15.	Landi F, Espín E, Rodrigues V, et al. Pathologic response grade after long-course neoadjuvant chemoradiation does not influence morbidity in locally advanced mid-low rectal cancer resected by laparoscopy. Int J Colorectal Dis, 2016, 31(7):1283-1290.
16.	Pecorelli N, Amodeo S, Frasson M, et al. Ten-year outcomes following laparoscopic colorectal resection:results of a randomized controlled trial. Int J Colorectal Dis, 2016, 31(7):1283-1290.
17.	Zhao D, Li Y, Wang S, et al. Laparoscopic versus open surgery for rectal cancer:a meta-analysis of 3-year follow-up outcomes. Int J Colorectal Dis, 2016, 31(4):805-811.
18.	Li S, Jiang F, Tu J, et al. Long-term oncologic outcomes of laparos-copic versus open surgery for middle and lower rectal cancer. PLoS One, 2015, 10(9):e0135884.
19.	Pai A, Marecik SJ, Park JJ, et al. Oncologic and clinicopathologic outcomes of robot-assisted total mesorectal excision for rectal cancer. Dis Colon Rectum, 2015, 58(7):659-667.
20.	Huscher CG, Bretagnol F, Corcione F. Laparoscopic colorectal cancer resection in high-volume surgical centers:long-term outcomes from the LAPCOLON Group Trial. World J Surg, 2015, 39(8):2045-2051.
21.	Zhou ZX, Zhao LY, Lin T, et al. Long-term oncologic outcomes of laparoscopic vs open surgery for stages Ⅱ and Ⅲ rectal cancer:a retrospective cohort study. World J Gastroenterol, 2015, 21(18):5505-5512.
22.	Marks H, Huang R, McKeever D, et al. Outcomes in 132 patients following laparoscopic total mesorectal excision (TME) for rectal cancer with greater than 5-year follow-up. Surg Endosc, 2016, 30(1):307-314.
23.	Bonjer HJ, Deijen CL, Abis GA, et al. A randomized trial of laparo-scopic versus open surgery for rectal cancer. N Engl J Med, 2015, 372(14):1324-1332.
24.	Cho MS, Baek SJ, Hur H, et al. Short and long-term outcomes of robotic versus laparoscopic total mesorectal excision for rectal cancer:a case-matched retrospective study. Medicine (Baltimore), 2015, 94(11):e522.
25.	Baek JH, Lee GJ, Lee WS. Comparison of long-term oncologic outcomes of stage Ⅲ colorectal cancer following laparoscopic versus open surgery. Ann Surg Treat Res, 2015, 88(1):8-14.

1. Weber PA, Merola S, Wasielewski A, et al. Telerobotic-assisted laparoscopic right and sigmoid colectomies for benign disease. Dis Colon Rectum, 2002, 45(12):1689-1696.
2. Kakeji Y, Konishi K, Ieiri S, et al. Robotic laparoscopic distal gastre-ctomy:a comparison of the da Vinci and Zeus systems. Int J Med Robot, 2006, 2(4):299-304.
3. Patriti A, Ceccarelli G, Bellochi R, et al. Robot-assisted laparoscopic total and partial gastric resection with D2 lymph node dissection for adenocarcinoma. Surg Endosc, 2008, 22(12):2753-2760.
4. 余佩武, 唐波, 曾冬竹, 等.达芬奇机器人胃癌根治术41例.中华胃肠外科杂志, 2012, 15(2):121-124.
5. 刘驰, 唐波, 郝迎学, 等.达芬奇机器人与腹腔镜胃癌手术近期疗效的对照研究.第三军医大学学报, 2013, 35(11):1164-1166.
6. Huang KH, Lan YT, Fang WL, et al. Comparison of the operative outcomes and learning curves between laparoscopic and robotic gastrectomy for gastric cancer. PLoS One, 2014, 9(10):e111499.
7. Baik SH, Kang CM, Lee WJ, et al. Robotic total mesorectal excision for the treatment of rectal cancer. J Robot Surg, 2007, 1(1):99-102.
8. Gómez Ruiz M, Alonso Martin J, Cagigas Fernández C, et al. Short-and mid-term outcomes of robotic-assisted total mesorectal excision for the treatment of rectal cancer. Our experience after 198 consecutive cases. Eur J Surg Oncol, 2016, 42(6):848-854.
9. Ghezzi TL, Luca F, Valvo M, et al. Robotic versus open total mesorectal excision for rectal cancer:comparative study of short and long-term outcomes. Eur J Surg Oncol, 2014, 40(9):1072-1079.
10. Serin KR, Gultekin FA, Batman B, et al. Robotic versus laparoscopic surgery for mid or low rectal cancer in male patients after neoadjuvant chemoradiation therapy:comparison of short-term outcomes. J Robot Surg, 2015, 9(3):187-194.
11. Luca F, Valvo M, Ghezzi TL, et al. Impact of robotic surgery on sexual and urinary functions after fully robotic nerve-sparing total mesorectal excision for rectal cancer. Ann Surg, 2013, 257(4):672-678.
12. Baek SK, Carmichael JC, Pigazzi A. Robotic surgery:colon and rectum. Cancer J, 2013, 19(2):140-146.
13. Baek JH, McKenzie S, Garcia-Aguilar J, et al. Oncologic outcomes of robotic-assisted total mesorectal excision for the treatment of rectal cancer. Ann Surg, 2010, 251(5):882-886.
14. Park EJ, Cho MS, Baek SJ, et al. Long-term oncologic outcomes of robotic low anterior resection for rectal cancer:a comparative study with laparoscopic surgery. Ann Surg, 2015, 261(1):129-137.
15. Landi F, Espín E, Rodrigues V, et al. Pathologic response grade after long-course neoadjuvant chemoradiation does not influence morbidity in locally advanced mid-low rectal cancer resected by laparoscopy. Int J Colorectal Dis, 2016, 31(7):1283-1290.
16. Pecorelli N, Amodeo S, Frasson M, et al. Ten-year outcomes following laparoscopic colorectal resection:results of a randomized controlled trial. Int J Colorectal Dis, 2016, 31(7):1283-1290.
17. Zhao D, Li Y, Wang S, et al. Laparoscopic versus open surgery for rectal cancer:a meta-analysis of 3-year follow-up outcomes. Int J Colorectal Dis, 2016, 31(4):805-811.
18. Li S, Jiang F, Tu J, et al. Long-term oncologic outcomes of laparos-copic versus open surgery for middle and lower rectal cancer. PLoS One, 2015, 10(9):e0135884.
19. Pai A, Marecik SJ, Park JJ, et al. Oncologic and clinicopathologic outcomes of robot-assisted total mesorectal excision for rectal cancer. Dis Colon Rectum, 2015, 58(7):659-667.
20. Huscher CG, Bretagnol F, Corcione F. Laparoscopic colorectal cancer resection in high-volume surgical centers:long-term outcomes from the LAPCOLON Group Trial. World J Surg, 2015, 39(8):2045-2051.
21. Zhou ZX, Zhao LY, Lin T, et al. Long-term oncologic outcomes of laparoscopic vs open surgery for stages Ⅱ and Ⅲ rectal cancer:a retrospective cohort study. World J Gastroenterol, 2015, 21(18):5505-5512.
22. Marks H, Huang R, McKeever D, et al. Outcomes in 132 patients following laparoscopic total mesorectal excision (TME) for rectal cancer with greater than 5-year follow-up. Surg Endosc, 2016, 30(1):307-314.
23. Bonjer HJ, Deijen CL, Abis GA, et al. A randomized trial of laparo-scopic versus open surgery for rectal cancer. N Engl J Med, 2015, 372(14):1324-1332.
24. Cho MS, Baek SJ, Hur H, et al. Short and long-term outcomes of robotic versus laparoscopic total mesorectal excision for rectal cancer:a case-matched retrospective study. Medicine (Baltimore), 2015, 94(11):e522.
25. Baek JH, Lee GJ, Lee WS. Comparison of long-term oncologic outcomes of stage Ⅲ colorectal cancer following laparoscopic versus open surgery. Ann Surg Treat Res, 2015, 88(1):8-14.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of da Vinci Robotic Surgical System in Radical Resection of Rectal Cancer: A Report of 456 Cases

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