Total mesorectal excision for mid and low rectal cancer: Laparoscopic vs robotic surgery

Table 1 Patient characteristics n (%)

	L-TME(n = 58)	R-TME(n = 53)	P value
Age1 (yr)	66 (33-80)	66 (42-84)	0.597
Sex			0.031
Male	42 (72.4)	27 (50.9)
Female	16 (27.6)	26 (49.1)
BMI1 (kg/m2)	24.6 (19-37)	24.6 (18-31)	0.512
ASA score			0.082
1	7 (12.1)	11 (20.8)
2	31 (53.4)	33 (62.3)
3	20 (34.5)	9 (16.9)
Neoadjuvant therapy	25 (43.1)	26 (49.1)	0.571
Tumour location from anal verge1 (cm)	8 (3-12)	8 (4-12)	0.607
CEA1	1.55 (0.6-51.6)	1.65 (0.5-11.1)	0.803
CA 19.91	7.85 (0.8-241)	7.5 (2-905)	0.896

¹Median (range). L-TME: Laparoscopic total mesorectal excision; R-TME: Robotic total mesorectal excision; BMI: Body mass index; ASA: American Society of Anesthesiologists.

Table 2 Perioperative outcomes n (%)

	L-TME	R-TME	P value
	(n = 58)	(n = 53)
Operative time1 (min)	192 (90-335)	342 (249-536)	< 0.001
Anastomosis			0.120
Mechanical transanal	54 (93.1)	53 (100)
Manual coloanal	4 (6.9)	0
Adjunctive procedure	8 (13.8)	5 (9.4)	0.562
Diverting ileostomy	43 (74.1)	41 (77.4)	0.825
Intraoperative blood loss2 (mL)	47.4 (0-400)	60.8 (0-400)	0.510
Conversion to laparotomy	1 (1.7)	2 (3.8)	0.605
Hospital stay1 (d)	8 (5-53)	6 (3-17)	< 0.001
First bowel movement1 (postoperative day)	1 (1-6)	1 (1-6)	0.904
Total morbidity	26 (44.8)	17 (32.1)	0.122
Surgical morbidity
Anastomotic leak	8 (13.8)	3 (5.7)	0.208
Peritoneal haemorrhage	2 (3.4)	1 (1.9)	0.534
Stomal stricture	3 (5.2)	1 (1.9)	0.620
Wound infection	2 (3.4)	0	0.496
Ileus	4 (6.8)	3 (5.7)	0.551
Abdominal pain3	2 (3.4)	3 (5.7)	0.457
Other surgical complications	5 (8.6)	3 (5.7)	0.410
Non surgical morbidity	11 (19.0)	6 (11.4)	0.302
Reoperation	8 (13.8)	3 (5.7)	0.208
Clavien-Dindo Classification			0.297
0	32 (55.2)	36 (67.9)
1	9 (15.5)	5 (9.4)
2	7 (12.1)	8 (15.1)
3a	2 (3.4)	1 (1.9)
3b	4 (6.8)	3 (5.7)
4a	2 (3.4)	0
4b	2 (3.4)	0

¹Median (range);

²Mean (range);

³Without other causes. L-TME: Laparoscopic total mesorectal excision; R-TME: Robotic total mesorectal excision.

Table 3 Pathologic evaluation n (%)

	L-TME	R-TME	P value
	(n = 58)	(n = 53)
TNM stage			0.716
Stage I	28 (48.3)	22 (41.5)
Stage II	11 (19.0)	8 (15.1)
Stage III	13 (22.4)	18 (34.0)
Pathological complete response	6 (10.3)	5 (9.4)	0.381
Total harvested lymph nodes1	11 (3-27)	18 (4-49)	< 0.001
DRM1 (cm)	1.5 (0.5-5)	2.5 (0.5-10)	< 0.001
DRM			0.729
Involved	1 (1.7)	1 (1.9)
Non involved	57 (98.3)	52 (98.1)
CRM			0.523
Involved	1 (1.7)	0
Non involved	57 (98.3)	53 (100)
Lymphovascular invasion	10 (17.2)	5 (9.4)	0.087

¹Median (range). L-TME: Laparoscopic total mesorectal excision; R-TME: Robotic total mesorectal excision; DRM: Distal resection margin; CRM: Circumferential resection margin.

Table 4 Long-term outcomes n (%)

	L-TME	R-TME	P value
	(n = 58)	(n = 53)
Adjuvant chemotherapy	25 (43.1)	27 (50.9)	0.700
Distant recurrence	5 (8.6)	9 (17.0)	0.265
Local recurrence	3 (5.2)	1 (1.9)	0.618
Overall mortalit	6 (10.3)	5 (9.4)	0.564
Mortality for rectal cancer	4 (6.9)	4 (7.5)	0.491
3-yr overall survival (%)	90.0	90.2	0.956
3-yr disease-free survival (%)	83.4	79.2	0.268

L-TME: Laparoscopic total mesorectal excision; R-TME: Robotic total mesorectal excision.