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Initial experiences of robotic versus conventional laparoscopic surgery for colorectal cancer, focusing on short-term outcomes: a matched case-control study.

Sawada H, Egi H, Hattori M, Suzuki T, Shimomura M, Tanabe K, Okajima M, Ohdan H - World J Surg Oncol (2015)

Bottom Line: Both groups were balanced in terms of age, gender, American Society of Anesthesiologists (ASA) score, body mass index (BMI), operative history, TNM staging, and tumor location.Moreover, in order to improve objectivity and approximate a randomized controlled study, we used the propensity score matching method.The matching was successful because the ROC analysis showed a well-balanced curve (C = 0.535).

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. dannte5426@yahoo.co.jp.

ABSTRACT

Background: Robotic surgery is a new technique with the benefits of a three-dimensional view, the ability to use multi-degree-of-freedom forceps, the elimination of physiological tremors, and a stable camera view. The aim of this study was to evaluate the feasibility and short-term outcomes of robotic surgery for colorectal cancer as initial cases, compared with conventional laparoscopic surgery.

Methods: From July 2010 to June 2013, ten patients with left-sided colon and rectal cancer underwent robotic surgery, and 121 received conventional laparoscopic surgery. Both groups were balanced in terms of age, gender, American Society of Anesthesiologists (ASA) score, body mass index (BMI), operative history, TNM staging, and tumor location. Moreover, in order to improve objectivity and approximate a randomized controlled study, we used the propensity score matching method. The matching was successful because the ROC analysis showed a well-balanced curve (C = 0.535).

Results: Following propensity score matching, ten patients were included in the robotic surgery group and 20 patients were included in the conventional laparoscopic surgery group. There were no significant differences in the short-term clinicopathologic outcomes between the robotic surgery group and the conventional laparoscopic surgery group. However, the operative time was significantly longer in the robotic surgery group than in the conventional laparoscopic surgery group.

Conclusions: There were no significant differences between the robotic surgery group and the conventional laparoscopic surgery group with respect to short-term clinicopathologic outcomes, with the exception of the operative time. Our early experience indicates that robotic surgery is a promising tool, particularly in patients with rectal cancer.

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Related in: MedlinePlus

Instruments of the da Vinci S-HD-assisted colorectal surgery device.
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Fig3: Instruments of the da Vinci S-HD-assisted colorectal surgery device.

Mentions: The robot used in this study was the da Vinci S Surgical System (Intuitive Surgical, Sunnyvale, CA, USA). We usually use three 8-mm trocars (Intuitive Surgical, Sunnyvale, CA, USA) and three 12-mm trocars (Ethicon, Inc., Cincinnati, OH, USA) (Figure 1). The trocar placement doing the medial to lateral approach (Figure 2A; lateral phase) and during the procedure in the pelvic space (Figure 2B; pelvic phase) is presented in Figure 2. We usually use monopolar scissors (R1) and cadiere forceps (R3 or R4) for the right hand and bipolar scissors (R2 or R5) for the left hand (Figure 3). Our procedure for lymph node dissection includes left colic artery-preserving D3 to maintain a good blood supply on the oral side of the colon.Figure 1


Initial experiences of robotic versus conventional laparoscopic surgery for colorectal cancer, focusing on short-term outcomes: a matched case-control study.

Sawada H, Egi H, Hattori M, Suzuki T, Shimomura M, Tanabe K, Okajima M, Ohdan H - World J Surg Oncol (2015)

Instruments of the da Vinci S-HD-assisted colorectal surgery device.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4363064&req=5

Fig3: Instruments of the da Vinci S-HD-assisted colorectal surgery device.
Mentions: The robot used in this study was the da Vinci S Surgical System (Intuitive Surgical, Sunnyvale, CA, USA). We usually use three 8-mm trocars (Intuitive Surgical, Sunnyvale, CA, USA) and three 12-mm trocars (Ethicon, Inc., Cincinnati, OH, USA) (Figure 1). The trocar placement doing the medial to lateral approach (Figure 2A; lateral phase) and during the procedure in the pelvic space (Figure 2B; pelvic phase) is presented in Figure 2. We usually use monopolar scissors (R1) and cadiere forceps (R3 or R4) for the right hand and bipolar scissors (R2 or R5) for the left hand (Figure 3). Our procedure for lymph node dissection includes left colic artery-preserving D3 to maintain a good blood supply on the oral side of the colon.Figure 1

Bottom Line: Both groups were balanced in terms of age, gender, American Society of Anesthesiologists (ASA) score, body mass index (BMI), operative history, TNM staging, and tumor location.Moreover, in order to improve objectivity and approximate a randomized controlled study, we used the propensity score matching method.The matching was successful because the ROC analysis showed a well-balanced curve (C = 0.535).

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. dannte5426@yahoo.co.jp.

ABSTRACT

Background: Robotic surgery is a new technique with the benefits of a three-dimensional view, the ability to use multi-degree-of-freedom forceps, the elimination of physiological tremors, and a stable camera view. The aim of this study was to evaluate the feasibility and short-term outcomes of robotic surgery for colorectal cancer as initial cases, compared with conventional laparoscopic surgery.

Methods: From July 2010 to June 2013, ten patients with left-sided colon and rectal cancer underwent robotic surgery, and 121 received conventional laparoscopic surgery. Both groups were balanced in terms of age, gender, American Society of Anesthesiologists (ASA) score, body mass index (BMI), operative history, TNM staging, and tumor location. Moreover, in order to improve objectivity and approximate a randomized controlled study, we used the propensity score matching method. The matching was successful because the ROC analysis showed a well-balanced curve (C = 0.535).

Results: Following propensity score matching, ten patients were included in the robotic surgery group and 20 patients were included in the conventional laparoscopic surgery group. There were no significant differences in the short-term clinicopathologic outcomes between the robotic surgery group and the conventional laparoscopic surgery group. However, the operative time was significantly longer in the robotic surgery group than in the conventional laparoscopic surgery group.

Conclusions: There were no significant differences between the robotic surgery group and the conventional laparoscopic surgery group with respect to short-term clinicopathologic outcomes, with the exception of the operative time. Our early experience indicates that robotic surgery is a promising tool, particularly in patients with rectal cancer.

Show MeSH
Related in: MedlinePlus