Robot-assisted surgery for rectal cancer in patients after neoadjuvant chemoradiotherapy Immediate results

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Abstract

Introduction. The benefits of robotic surgery for rectal cancer remain controversial. Only a few studies have evaluated the safety and feasibility of robot-assisted surgery after neoadjuvant chemoradiotherapy.

Aim. Our study aimed to compare the short-term outcomes of robotic and traditional laparoscopic surgery after neoadjuvant chemoradiotherapy for rectal cancer.

Materials and methods. This retrospective study was based on the analysis of 210 medical records of patients with rectal tumors who underwent robot-assisted and laparoscopic-assisted surgeries after neoadjuvant chemoradiotherapy from 2015 to 2021.

Results. There was no significant difference in short-term outcomes such as operation time, conversion rate, anastomotic leakage, and quality of circular resection margin. However, a significant difference was noted in the quality of total mesorectal excision. Grade 3 quality in the R group was 93.9 %, while in the L group it was 74.07 % (Odds Ratio (OR) 2.335; 95 % Confidence Interval (CI) 1.107–4.925). A statistically significant difference was also found in the rate of performing sphincter-preserving procedures, with 12.2 % in the R group and 50 % in the L group (OR 0.139; 95 % CI 0.066–0.293).

Conclusion. The advantages of the robotic surgical system in the surgical treatment of rectal cancer in patients after neoadjuvant chemoradiotherapy improve clinical outcomes, primarily reflected in the rate of sphincter-preserving operations. Additionally, it provides a trend towards achieving more oncologically adequate tumor removal compared to laparoscopic procedures.

About the authors

M. E. Moiseev

City Hospital No. 40 Resort District of Saint Petersburg

Author for correspondence.
Email: dr.michail.moiseev@gmail.com
ORCID iD: 0000-0002-6180-6695

Mikhail Evgenievich Moiseev 

9 St. Borisov, Sestroretsk, Saint Peterburg 197706

Russian Federation

V. N. Kotiv

Military Medical Academy named after S.M. Kirov, Ministry of Defense of Russia

Email: fake@neicon.ru
ORCID iD: 0000-0001-7537-1218

lit. Zh, 6 Akademika Lebedeva St., Saint Peterburg 194044

Russian Federation

D. V. Gladyshev

City Hospital No. 40 Resort District of Saint Petersburg;
Military Medical Academy named after S.M. Kirov, Ministry of Defense of Russia;
St. Petersburg State University

Email: fake@neicon.ru
ORCID iD: 0000-0001-5318-2619

9 St. Borisov, Sestroretsk, Saint Peterburg 197706,

lit. Zh, 6 Akademika Lebedeva St., Saint Peterburg 194044,

7–9 Universitetskaya embankment, Saint Peterburg 199034,

Russian Federation

V. A. Vetoshkin

City Hospital No. 40 Resort District of Saint Petersburg;
St. Petersburg Research Institute of Phthisiopulmonology, Ministry of Health of Russia

Email: fake@neicon.ru
ORCID iD: 0000-0001-5346-9257

9 St. Borisov, Sestroretsk, Saint Peterburg 197706,

2–4 Ligovsky Prospekt, Saint Peterburg 191036

Russian Federation

S. A. Kovalenko

City Hospital No. 40 Resort District of Saint Petersburg

Email: fake@neicon.ru
ORCID iD: 0000-0002-5850-0599

9 St. Borisov, Sestroretsk, Saint Peterburg 197706

Russian Federation

R. A. Murashko

Clinical Oncology Dispensary No. 1, Ministry of Health of Krasnodar region

Email: fake@neicon.ru
ORCID iD: 0000-0001-8084-8770

146 Dimitrova St., Krasnodar 350040

Russian Federation

S. Z. Khondziya

Clinical Oncology Dispensary No. 1, Ministry of Health of Krasnodar region

Email: fake@neicon.ru

146 Dimitrova St., Krasnodar 350040

Russian Federation

V. Yu. Svitich

City Hospital No. 40 Resort District of Saint Petersburg

Email: fake@neicon.ru
ORCID iD: 0009-0002-2293-0527

9 St. Borisov, Sestroretsk, Saint Peterburg 197706

Russian Federation

S. S. Gnedash

City Hospital No. 40 Resort District of Saint Petersburg

Email: fake@neicon.ru
ORCID iD: 0009-0003-4743-3014

9 St. Borisov, Sestroretsk, Saint Peterburg 197706

Russian Federation

A. S. Butorina

St. Petersburg State University

Email: fake@neicon.ru
ORCID iD: 0000-0002-7342-9815

7–9 Universitetskaya embankment, Saint Peterburg 199034

Russian Federation

A. S. Skobaro

St. Petersburg State University

Email: fake@neicon.ru
ORCID iD: 0009-0003-8641-9311

7–9 Universitetskaya embankment, Saint Peterburg 199034

Russian Federation

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