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Cited 44 time in webofscience Cited 51 time in scopus
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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
Sep-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://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/13232
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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Kwak, Jung Myun
Anam Hospital (Department of Colon and Rectal Surgery, Anam Hospital)
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