1. Open versus robotic-assisted techniques for multivisceral pelvic resections of locally advanced or recurrent colorectal and anal cancers: short-term outcomes from a single centre.
- Author
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Wyatt J, O'Connell E, Choi M, Powell SG, Hanchanale V, Ahmed S, and Javed MA
- Subjects
- Humans, Male, Female, Retrospective Studies, Middle Aged, Aged, Treatment Outcome, Length of Stay statistics & numerical data, Postoperative Complications etiology, Margins of Excision, Blood Loss, Surgical statistics & numerical data, Adult, Robotic Surgical Procedures methods, Neoplasm Recurrence, Local, Pelvic Exenteration methods, Pelvic Exenteration adverse effects, Anus Neoplasms surgery, Anus Neoplasms pathology, Colorectal Neoplasms surgery, Colorectal Neoplasms pathology
- Abstract
Background: Pelvic exenterations are now established as a standard of care for locally advanced and recurrent rectal cancer. Traditionally, these radical and complex operations have been performed via an open approach, but with the increasing expertise in robotic-assisted surgery (RAS), there is scope to perform such cases robotically. This study compares outcomes from open and RAS pelvic exenterations., Methods: This retrospective observational study includes all pelvic exenterations for locally advanced or recurrent colorectal cancers performed in a single centre between September 2018 and September 2023. Cases were grouped into open or RAS surgery and classified in terms of operative extent and complexity. The primary outcome was resection margin status. Secondary outcomes were postoperative morbidity, length of stay and blood loss., Results: Thirty-three patients were included. Nineteen (57.6%) cases utilised an open technique, and 14 (42.4%) used RAS. Patient characteristics and operative complexity were equivalent between groups. R0 rate (63.1% vs 71.4%, p = 0.719), median haemoglobin drop (19 (11-30) g/L vs 13 (5-26) g/L, p = 0.208) and postoperative morbidity (18/19 (94.7%) vs 9/14 (64.3%), p = 0.062) were equivalent. Length of stay (16.0 days (8-25) vs 9.5 days (6-16), p = 0.047) was shorter in the RAS group., Conclusions: Short-term surgical and histopathological outcomes are equivalent in this small cohort of patients. This study suggests that RAS may be a safe and effective method for performing pelvic exenterations for colorectal malignancies. Larger-scale and robustly designed prospective studies are required to confirm these preliminary findings and report on long-term oncological outcomes., Competing Interests: Declarations Conflict of interest The authors declare that no funds, grants, or other support were received during the preparation of this manuscript. The authors have no relevant financial or non-financial interests to disclose. Ethical approval Ethical approval was not required for the completion and publication of this retrospective observational study. Informed consent Consent was not required for the completion and publication of this study., (© 2024. The Author(s).)
- Published
- 2024
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