PMID- 30693389
OWN - NLM
STAT- MEDLINE
DCOM- 20200526
LR  - 20200526
IS  - 1432-2218 (Electronic)
IS  - 0930-2794 (Print)
IS  - 0930-2794 (Linking)
VI  - 33
IP  - 11
DP  - 2019 Nov
TI  - The oncological and surgical safety of robot-assisted surgery in colorectal 
      cancer: outcomes of a longitudinal prospective cohort study.
PG  - 3644-3655
LID - 10.1007/s00464-018-06653-2 [doi]
AB  - BACKGROUND: Colorectal cancer is one of the most common cancers worldwide. 
      Laparoscopic colorectal surgery (LCRS) is a frequently used modality. A new 
      development in minimally invasive surgery is robot-assisted colorectal surgery 
      (RACRS). METHODS: Prospectively collected data of 378 consecutive patients who 
      underwent RACRS or LCRS for stage I-III colorectal cancer from Dec 2014 to Oct 
      2017 were analyzed. Primary outcome was oncological outcome (radical margins, 
      number of retrieved lymph nodes, locoregional recurrence). Secondary outcomes 
      were distant metastases, overall and disease-free survival, operation time, 
      conversion, length of hospital stay, and intra- and post-operative complications. 
      RESULTS: 206 RACRS (129 colon and 77 rectal) and 172 LCRS (138 colon and 34 
      rectal) procedures were included. Baseline characteristics were similar. Overall 
      median follow-up time was 15 months (0.2-36). Oncological outcome was similar. In 
      colon cancer, radical margins were achieved in 99.3% in RACRS group versus 98.6% 
      in LCRS group (p = 0.60), the average number of harvested lymph nodes was 16 +/- 6 
      versus 18 +/- 7 (p = 0.16), and locoregional recurrence rate in 24 months was 3.8% 
      vs 3.8% (p = 0.99), respectively. In rectal cancer, radical margins were achieved 
      in 89.6% in RACRS group versus 94.3% in LCRS group (p = 0.42), the average number 
      of harvested lymph nodes was 16 +/- 8 versus 15 +/- 4 (p = 0.51), and locoregional 
      recurrence rate in 24 months was 9.5 versus 5.6% (p = 0.42), respectively. 
      Incidence of metastasis, survival rates, operation time, length of hospital stay, 
      and number of severe post-operative complications measured by Clavien-Dindo 
      scores did not differ between RACRS and LCRS groups. Conversion and 
      intra-operative complication rates were significantly lower in the RACRS group as 
      compared to the LCRS group (3% vs 9%, p = 0.008 and 2% vs 8%, p = 0.003, 
      respectively). CONCLUSION: RACRS is safe in the treatment of patients with stage 
      I-III colorectal cancer. Oncological outcome did not differ between RACRS and 
      LCRS groups. RACRS had lower conversion and intra-operative complication rates.
FAU - Polat, F
AU  - Polat F
AD  - Department of surgery, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.
FAU - Willems, L H
AU  - Willems LH
AUID- ORCID: 0000-0002-2728-9663
AD  - Department of surgery, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands. 
      l.willems@cwz.nl.
FAU - Dogan, K
AU  - Dogan K
AD  - Department of gastro-intestinal and oncologic surgery, Radboud University Medical 
      Centre, Nijmegen, The Netherlands.
FAU - Rosman, C
AU  - Rosman C
AD  - Department of gastro-intestinal and oncologic surgery, Radboud University Medical 
      Centre, Nijmegen, The Netherlands.
LA  - eng
PT  - Journal Article
DEP - 20190128
PL  - Germany
TA  - Surg Endosc
JT  - Surgical endoscopy
JID - 8806653
SB  - IM
MH  - Aged
MH  - Colectomy/*methods
MH  - Colorectal Neoplasms/diagnosis/*surgery
MH  - Disease-Free Survival
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Incidence
MH  - Intraoperative Complications/*epidemiology
MH  - Length of Stay
MH  - Male
MH  - Margins of Excision
MH  - Neoplasm Recurrence, Local/epidemiology
MH  - Neoplasm Staging
MH  - Netherlands/epidemiology
MH  - Operative Time
MH  - Postoperative Complications/*epidemiology
MH  - Prospective Studies
MH  - Robotics/*methods
MH  - Survival Rate/trends
PMC - PMC6795614
OTO - NOTNLM
OT  - Colorectal cancer
OT  - DaVinci Xi
OT  - Laparoscopic surgery
OT  - Oncological safety
OT  - Robotic surgery
COIS- Fatih Polat, Loes Willems, Kemal Dogan, and Camiel Rosman have no conflicts of 
      interest or financial ties to disclose.
EDAT- 2019/01/30 06:00
MHDA- 2020/05/27 06:00
PMCR- 2019/01/28
CRDT- 2019/01/30 06:00
PHST- 2018/05/22 00:00 [received]
PHST- 2018/12/24 00:00 [accepted]
PHST- 2019/01/30 06:00 [pubmed]
PHST- 2020/05/27 06:00 [medline]
PHST- 2019/01/30 06:00 [entrez]
PHST- 2019/01/28 00:00 [pmc-release]
AID - 10.1007/s00464-018-06653-2 [pii]
AID - 6653 [pii]
AID - 10.1007/s00464-018-06653-2 [doi]
PST - ppublish
SO  - Surg Endosc. 2019 Nov;33(11):3644-3655. doi: 10.1007/s00464-018-06653-2. Epub 
      2019 Jan 28.