Robot-assisted intersphincteric resection for low rectal cancer: technique and short-term outcome for 29 consecutive patients
- Authors
- Leong, Quor M.; Son, Dong N.; Cho, Jae S.; Baek, Se J.; Kwak, Jung M.; Amar, Azali H.; Kim, Seon H.
- Issue Date
- 9월-2011
- Publisher
- SPRINGER
- Keywords
- Cancer; Intersphincteric; Rectal; Robot
- Citation
- SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, v.25, no.9, pp.2987 - 2992
- Indexed
- SCIE
SCOPUS
- Journal Title
- SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
- Volume
- 25
- Number
- 9
- Start Page
- 2987
- End Page
- 2992
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/111654
- DOI
- 10.1007/s00464-011-1657-6
- ISSN
- 0930-2794
- Abstract
- Intersphincteric resection (ISR) for low rectal cancer has been described as the ultimate sphincter-saving procedure. Laparoscopic ISR has been proved safe with early postoperative benefits. Recently, some colorectal surgeons have begun to perform robot-assisted ISR to harness the advantages of the da Vinci robotic system. The authors present their short-term results for a robotic technique of ISR. Data from 29 consecutive patients at a single institution with very low rectal cancer (< 4 cm) from the anal verge who underwent robot-assisted ISR were prospectively collected between December 2007 and March 2010. The study enrolled 23 men and 6 women with a median age of 61.5 years (range, 36-82 years). Their median body mass index (BMI) was 23.3 kg/m(2) (range, 17.9-32.5 kg/m(2)). The median distance of the tumor from the anal verge was 3 cm (range, 1-4 cm). The median operative time was 325 min (range, 235-435 min), with a console time of 130 min (range, 110-210 min). There were no conversions to open surgery. A protecting ileostomy was performed for all the patients. The median blood loss was less than 50 ml (range, < 50-1,000 ml). The median size of the tumor was 3 cm (range, 0-6.9 cm), and the median number of lymph nodes harvested was 16 (range, 1-44). The median distal margin was 0.8 cm (range, 0-4 cm), and one margin was positive. The circumferential margin was negative (> 2 mm) for 27 patients. Therefore, complete resection (R0) was achieved for 26 (90%) of the 29 patients. The median hospital stay was 9 days (range, 5-15 days). Nine patients experienced complications, including three anastomotic leaks (10%). All the leaks were managed conservatively. No surgical mortalities occurred. Robot-assisted intersphincteric resection for very low rectal cancer is feasible, and its short-term outcome is acceptable.
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