• Francesco Feroci, Andrea Vannucchi, Paolo Pietro Bianchi, Stefano Cantafio, Alessia Garzi, Giampaolo Formisano, and Marco Scatizzi.
• Francesco Feroci, Andrea Vannucchi, Stefano Cantafio, Alessia Garzi, Marco Scatizzi, Department of General and Oncological Surgery, Santo Stefano Hospital, 59100 Prato, Italy.
• World J. Gastroenterol. 2016 Apr 7; 22 (13): 3602-10.

AimTo compare the short- and long-term outcomes of laparoscopic and robotic surgery for middle and low rectal cancer.MethodsThis is a retrospective study on a prospectively collected database containing 111 patients who underwent minimally invasive rectal resection with total mesorectal excision (TME) with curative intent between January 2008 and December 2014 (robot, n = 53; laparoscopy, n = 58). The patients all had a diagnosis of middle and low rectal adenocarcinoma with stage I-III disease. The median follow-up period was 37.4 mo. Perioperative results, morbidity a pathological data were evaluated and compared. The 3-year overall survival and disease-free survival rates were calculated and compared.ResultsPatients were comparable in terms of preoperative and demographic parameters. The median surgery time was 192 min for laparoscopic TME (L-TME) and 342 min for robotic TME (R-TME) (P < 0.001). There were no differences found in the rates of conversion to open surgery and morbidity. The patients who underwent laparoscopic surgery stayed in the hospital two days longer than the robotic group patients (8 d for L-TME and 6 d for R-TME, P < 0.001). The pathologic evaluation showed a higher number of harvested lymph nodes in the robotic group (18 for R-TME, 11 for L-TME, P < 0.001) and a shorter distal resection margin for laparoscopic patients (1.5 cm for L-TME, 2.5 cm for R-TME, P < 0.001). The three-year overall survival and disease-free survival rates were similar between groups.ConclusionBoth L-TME and R-TME achieved acceptable clinical and oncologic outcomes. The robotic technique showed some advantages in rectal surgery that should be validated by further studies.

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