Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jun 27, 2024; 16(6): 1681-1690
Published online Jun 27, 2024. doi: 10.4240/wjgs.v16.i6.1681
Comparative analysis of the short and medium-term efficacy of the Da Vinci robot versus laparoscopic total mesangectomy for rectal cancer
Wei-Ge Gao, Wen Shi, Xu-Chen Gong, Zhi-Wen Li, Yiminjiang Tuoheti
Wei-Ge Gao, Wen Shi, Xu-Chen Gong, Yiminjiang Tuoheti, Department of Anorectal Surgery, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, Xinjiang Uygur Autonomous Region, China
Zhi-Wen Li, Department of Anus and Intestine Surgery, Cancer Hospital of Chinese Academy of Medical Sciences, Beijing 100084, China
Author contributions: Gao WG wrote the manuscript; Shi W and Gong XC collected the data; Tuoheti Y and Li ZW guided the study; and all authors reviewed, edited, and approved the final manuscript and revised it critically for important intellectual content, gave final approval of the version to be published, and agreed to be accountable for all aspects of the work.
Supported by the Natural Science Foundation of Xinjiang Uygur Autonomous Region, No. 2020D01C112.
Institutional review board statement: This study was approved by the Ethics Committee of the People’s Hospital of Xinjiang Uygur Autonomous Region, No. 2024002141255.
Informed consent statement: All patients and their families signed informed consent before surgery.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The technical appendix, statistical code, and dataset are available from the corresponding author at email: gfxgwg@163.com.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei-Ge Gao, Doctor, Department of Anorectal Surgery, People’s Hospital of Xinjiang Uygur Autonomous Region, No. 91 Tianchi Road, Urumqi 830001, Xinjiang Uygur Autonomous Region, China. 36724580@qq.com
Received: February 20, 2024
Revised: April 9, 2024
Accepted: April 26, 2024
Published online: June 27, 2024
Processing time: 131 Days and 1 Hours
Abstract
BACKGROUND

The Da Vinci robot-assisted surgery technique has been widely used in laparoscopic mesangectomy for rectal cancer. However, the short-term efficacy of these procedures compared to traditional laparoscopic surgery remains controversial. The purpose of this study was to compare and analyze the short- and medium-term efficacy of Da Vinci robot and laparoscopic surgery in total mesangectomy (TME) for rectal cancer, so as to provide guidance and reference for clinical practice.

AIM

To investigate the safety and long-term efficacy of robotic and laparoscopic total mesorectal resection for the treatment of rectal cancer.

METHODS

The clinicopathologic data of 240 patients who underwent TME for rectal cancer in the Anorectal Department of People’s Hospital of Xinjiang Uygur Autonomous Region from August 2018 to March 2023 were retrospectively analyzed. Among them, 112 patients underwent laparoscopic TME (L-TME) group, and 128 patients underwent robotic TME (R-TME) group. The intraoperative, postoperative, and follow-up conditions of the two groups were compared.

RESULTS

The conversion rate of the L-TME group was greater than that of the R-TME group (5.4% vs 0.8%, χ2 = 4.417, P = 0.036). The complication rate of the L-TME group was greater than that of the R-TME group (32.1% vs 17.2%, χ2 = 7.290, P = 0.007). The percentage of positive annular margins in the L-TME group was greater than that in the R-TME group (7.1% vs 1.6%, χ2 = 4.658, P = 0.031). The 3-year disease-free survival (DFS) rate and overall survival (OS) rate of the L-TME group were lower than those of the R-TME group (74.1% vs 85.2%, χ2 = 4.962, P = 0.026; 81.3% vs 91.4%, χ2 = 5.494, P = 0.019); in patients with American Joint Committee on Cancer stage III DFS rate and OS rate in the L-TME group were significantly lower than those in the R-TME group (52.5% vs 76.1%, χ2 = 5.799, P = 0.016; 65.0% vs 84.8%, χ2 = 4.787, P = 0.029).

CONCLUSION

Compared with the L-TME group, the R-TME group had a better tumor prognosis and was more favorable for patients with rectal cancer, especially for patients with stage III rectal cancer.

Keywords: Rectal tumor, Robots, Laparoscopy, Total mesangectomy, Survival prognosis, Retrospective analysis

Core Tip: This study compared the short- and medium-term efficacy of Da Vinci robot-assisted surgery with traditional laparoscopic surgery in total mesangectomy for rectal cancer, involving indexes such as operation time, postoperative complications, postoperative pain, and postoperative rehabilitation. By comparing and analyzing the advantages and disadvantages of the two surgical methods, the influence on the treatment effect and quality of life of the patients was evaluated, and the scientific basis for clinical decision-making was provided.