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©The Author(s) 2024.
World J Gastrointest Surg. Jun 27, 2024; 16(6): 1558-1570
Published online Jun 27, 2024. doi: 10.4240/wjgs.v16.i6.1558
Published online Jun 27, 2024. doi: 10.4240/wjgs.v16.i6.1558
Table 1 Baseline characteristics, n (%)
| Item | Before matching | P value | After matching | P value | ||
| RALAR, n = 125 | LALAR, n = 279 | RALAR, n = 111 | LALAR, n = 111 | |||
| Gender | 0.871 | 0.8961 | ||||
| Male | 76 (60.8) | 172 (61.6) | 67 (60.4) | 65 (58.6) | ||
| Female | 49 (39.2) | 107 (38.4) | 44 (39.6) | 46 (41.4) | ||
| Age (yr) | 62 (55-68) | 63 (54-68) | 0.957 | 62 (55-66) | 61 (53-68) | 0.761 |
| Preoperative hemoglobin (g/L) | 135.0 (123.5-143.5) | 134.0 (123.0-145.0) | 0.593 | 131.7 ± 15.7 | 133.1 ± 17.5 | 0.510 |
| Preoperative albumin (g/L) | 39.5 ± 3.0 | 39.1 ± 3.2 | 0.246 | 39.4 ± 3.0 | 39.8 ± 3.3 | 0.430 |
| Preoperative intestinal obstruction | 8 (6.4) | 44 (15.8) | 0.009 | 8 (7.2) | 7 (6.3) | 1.0001 |
| Comorbidity | ||||||
| Cardiovascular diseases | 48 (38.4) | 106 (38.0) | 0.938 | 44 (39.6) | 38 (34.2) | 0.4411 |
| Cerebrovascular disorders | 11 (8.8) | 38 (13.6) | 0.170 | 10 (9.0) | 10 (9.0) | 1.0001 |
| Diabetes mellitus | 16 (12.8) | 41 (14.7) | 0.613 | 13 (11.7) | 12 (10.8) | 1.0001 |
| Lung diseases | 43 (34.4) | 96 (34.4) | 0.999 | 36 (32.4) | 38 (34.2) | 0.8851 |
| Liver diseases | 9 (7.2) | 8 (2.9) | 0.045 | 4 (3.6) | 5 (4.5) | 1.0001 |
| Previous abdominal surgery | 12 (9.6) | 33 (11.8) | 0.511 | 11 (9.9) | 15 (13.5) | 0.5231 |
| History of smoking | 47 (37.6) | 81 (29.0) | 0.087 | 39 (35.1) | 36 (32.4) | 0.7611 |
| Height of tumor from anal verge (cm) | 10 (8.0-13.5) | 10 (6.0-10.0) | 0.005 | 10 (8.0-12.0) | 10 (8.0-12.0) | 0.754 |
| Preventive stoma | 23 (18.4) | 111 (39.8) | 0.000 | 22 (19.8) | 23 (20.7) | 1.0001 |
| ASA score | 0.340 | 0.602 | ||||
| I | 0 | 1 (0.4) | 0 | 0 | ||
| II | 102 (81.6) | 214 (76.7) | 90 (81.1) | 93 (83.8) | ||
| III | 23 (18.4) | 64 (22.9) | 21 (18.9) | 18 (16.2) | ||
| Classification of NYHA heart function | 0.837 | 0.893 | ||||
| I | 77 (61.6) | 170 (60.9) | 67 (60.4) | 68 (61.3) | ||
| II | 48 (38.4) | 106 (38.0) | 44 (39.6) | 43 (38.7) | ||
| III | 0 | 3 (1.1) | 0 | 0 | ||
| BMI (kg/m2) | 24.2 (22.8-25.9) | 24.2 (22.1-26.7) | 0.780 | 24.5 ± 2.8 | 24.6 ± 3.5 | 0.795 |
| Differentiation | 0.053 | 0.317 | ||||
| Low | 3 (2.4) | 37 (13.3) | 3 (2.7) | 4 (3.6) | ||
| Medium | 114 (91.2) | 218 (78.1) | 102 (91.9) | 95 (85.6) | ||
| High | 8 (6.4) | 24 (8.6) | 6 (5.4) | 12 (10.8) | ||
| Maximum tumor diameter (cm) | 4 (3.0-5.0) | 4 (3.5-5.0) | 0.128 | 4 (3.0-5.0) | 4 (3.0-5.0) | 0.693 |
| Pathological T stage | 0.693 | 0.925 | ||||
| Tis | 0 | 2 (0.7) | 0 | 2 (1.8) | ||
| 1 | 10 (8.0) | 15 (5.4) | 9 (8.1) | 7 (6.3) | ||
| 2 | 34 (27.2) | 70 (25.1) | 32 (28.8) | 26 (23.4) | ||
| 3 | 74 (59.2) | 185 (66.3) | 64 (57.7) | 74 (66.7) | ||
| 4a | 7 (5.6) | 7 (2.5) | 6 (5.4) | 2 (1.8) | ||
| Pathological N stage | 0.046 | 0.534 | ||||
| 0 | 80 (64.0) | 154 (55.2) | 69 (62.2) | 72 (64.9) | ||
| 1a | 19 (15.2) | 38 (13.6) | 18 (16.2) | 17 (15.3) | ||
| 1b | 13 (10.4) | 38 (13.6) | 12 (10.8) | 12 (10.8) | ||
| 1c | 0 | 7 (2.5) | 0 | 2 (1.8) | ||
| 2a | 8 (6.4) | 19 (6.8) | 8 (7.2) | 6 (5.4) | ||
| 2b | 5 (4.0) | 23 (8.2) | 4 (3.6) | 2 (1.8) | ||
| Pathological TNM stage | 0.140 | 0.712 | ||||
| 0 | 0 | 2 (0.7) | 0 | 2 (1.8) | ||
| I | 34 (27.2) | 69 (24.7) | 31 (27.9) | 28 (25.2) | ||
| IIA | 43 (34.4) | 81 (29.0) | 36 (32.4) | 41 (36.9) | ||
| IIB | 3 (2.4) | 2 (0.7) | 2 (1.8) | 1 (0.9) | ||
| IIIA | 9 (7.2) | 15 (5.4) | 9 (8.1) | 5 (4.5) | ||
| IIIB | 30 (24.0) | 85 (30.5) | 28 (25.2) | 31 (27.9) | ||
| IIIC | 6 (4.8) | 25 (9.0) | 5 (4.5) | 3 (2.7) |
Table 2 Perioperative outcomes, n (%) or median (interquartile range)
| RALAR, n = 111 | LALAR, n = 111 | P value | |
| Conversion to laparotomy | 0 | 2 (1.8) | 0.4982 |
| Approximate intraoperative blood loss (mL) | 50 (20-50) | 50 (30-50) | 0.276 |
| Intraoperative blood transfusion | 4 (3.6) | 3 (2.7) | 1.0001 |
| Distal resection margin | 1.0002 | ||
| Involved | 0 | 1 (0.9) | |
| Harvested lymph nodes | 14 (11-16) | 13 (11-17) | 0.627 |
| Harvested positive lymph nodes | 0 (0-1) | 0 (0-1) | 0.317 |
| Duration of surgery (min) | 187 (160-215) | 185 (155-230) | 0.977 |
| Intraoperative dose of sufentanil (μg/kg/min) | 0.0050 (0.0040-0.0062) | 0.0048 (0.0040-0.0064) | 0.948 |
| Time to first flatus (d) | 2(2-2) | 3 (3-3) | 0.000 |
| Time to first fluid diet (d) | 4 (3-4) | 5 (4-6) | 0.001 |
| Postoperative indwelling catheter time (d) | 2 (1-3) | 4 (3-5) | 0.000 |
| Total cost of hospitalization (dollars) | 10777 (10780-11850) | 10550 (8766-11715) | 0.012 |
| Length of hospital stay after surgery (d) | 5 (5-7) | 7 (6-8) | 0.009 |
| Readmission within 30 d after operation | 1 (0.9) | 1 (0.9) | 1.0001 |
| Reoperation within 30 d after operation | 0 | 1 (0.9) | 1.0002 |
Table 3 Complications within 30 d after surgery, n (%)
| RALAR (n = 111) | LALAR (n = 111) | P value | P value | |||||||||
| I | II | IIIa | IIIb | Overall | I | II | IIIa | IIIb | Overall | Overall | ≥ III | |
| Overall | 0 | 14 | 1 | 0 | 15 (13.5) | 3 | 7 | 2 | 2 | 14 (12.6) | 1.0001 | 0.3751 |
| Anastomotic leakage | 0 | 12 | 1 | 0 | 13 (11.7) | 1 | 6 | 0 | 2 | 9 (8.1) | 0.4811 | 1.0001 |
| Anastomotic stenosis | 0 | 0 | 0 | 0 | 0 | 2 | 0 | 0 | 0 | 2 (1.8) | 0.4982 | |
| Intestinal obstruction | 0 | 1 | 0 | 0 | 1 (0.9) | 0 | 2 | 1 | 0 | 3 (2.7) | 0.6251 | 1.0002 |
| Intraabdominal infection | 0 | 2 | 0 | 0 | 2 (1.8) | 0 | 2 | 0 | 1 | 3 (2.7) | 1.0001 | 1.0002 |
| Hemoperitoneum | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 1 (0.9) | 1.0002 | 1.0002 |
| Pneumonia | 0 | 0 | 0 | 0 | 0 | 0 | 2 | 0 | 0 | 2 (1.8) | 0.4982 | |
| Pulmonary atelectasis | 0 | 0 | 0 | 0 | 0 | 4 | 0 | 0 | 0 | 4 (3.6) | 0.1222 | |
| Venous thrombosis | 0 | 1 | 0 | 0 | 1 (0.9) | 0 | 0 | 0 | 0 | 0 | 1.0002 | |
Table 4 Subgroup analysis of anastomotic leakage, n (%)
| Anastomotic leakage | P value | |
| BMI ≥ 25 (kg/m2) | 0.428 | |
| RALAR (n = 45) | 8 (17.8) | |
| LALAR (n = 50) | 6 (12.0) | |
| Maximum tumor diameter ≥ 6 cm | 0.3301 | |
| RALAR (n = 14) | 4 (28.6) | |
| LALAR (n = 12) | 1 (8.3) |
- Citation: Long SX, Wang XN, Tian SB, Bi YF, Gao SS, Wang Y, Guo XB. Robotic-assisted low anterior resection for rectal cancer shows similar clinical efficacy to laparoscopic surgery: A propensity score matched study. World J Gastrointest Surg 2024; 16(6): 1558-1570
- URL: https://www.wjgnet.com/1948-9366/full/v16/i6/1558.htm
- DOI: https://dx.doi.org/10.4240/wjgs.v16.i6.1558