Robot-assisted intersphincteric resection for low rectal cancer

Technique and short-term outcome for 29 consecutive patients

Quor M. Leong, Dong N. Son, Jae S. Cho, Se-Jin Baek, Jung-Myun Kwak, Azali H. Amar, Seon Hahn Kim

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Background 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. Methods 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. Results 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/m2 (range, 17.9-32.5 kg/m2). 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. Conclusion Robot-assisted intersphincteric resection for very low rectal cancer is feasible, and its short-termoutcome is acceptable.

Original languageEnglish
Pages (from-to)2987-2992
Number of pages6
JournalSurgical Endoscopy and Other Interventional Techniques
Volume25
Issue number9
DOIs
Publication statusPublished - 2011 Sep 1

Fingerprint

Rectal Neoplasms
Robotics
Anastomotic Leak
Length of Stay
Mortality

Keywords

  • Cancer
  • Intersphincteric
  • Rectal
  • Robot

ASJC Scopus subject areas

  • Surgery

Cite this

Robot-assisted intersphincteric resection for low rectal cancer : Technique and short-term outcome for 29 consecutive patients. / Leong, Quor M.; Son, Dong N.; Cho, Jae S.; Baek, Se-Jin; Kwak, Jung-Myun; Amar, Azali H.; Kim, Seon Hahn.

In: Surgical Endoscopy and Other Interventional Techniques, Vol. 25, No. 9, 01.09.2011, p. 2987-2992.

Research output: Contribution to journalArticle

@article{702a50d37d344c9ca97aa78e6245d4bc,
title = "Robot-assisted intersphincteric resection for low rectal cancer: Technique and short-term outcome for 29 consecutive patients",
abstract = "Background 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. Methods 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. Results 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/m2 (range, 17.9-32.5 kg/m2). 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. Conclusion Robot-assisted intersphincteric resection for very low rectal cancer is feasible, and its short-termoutcome is acceptable.",
keywords = "Cancer, Intersphincteric, Rectal, Robot",
author = "Leong, {Quor M.} and Son, {Dong N.} and Cho, {Jae S.} and Se-Jin Baek and Jung-Myun Kwak and Amar, {Azali H.} and Kim, {Seon Hahn}",
year = "2011",
month = "9",
day = "1",
doi = "10.1007/s00464-011-1657-6",
language = "English",
volume = "25",
pages = "2987--2992",
journal = "Surgical Endoscopy",
issn = "0930-2794",
publisher = "Springer New York",
number = "9",

}

TY - JOUR

T1 - Robot-assisted intersphincteric resection for low rectal cancer

T2 - Technique and short-term outcome for 29 consecutive patients

AU - Leong, Quor M.

AU - Son, Dong N.

AU - Cho, Jae S.

AU - Baek, Se-Jin

AU - Kwak, Jung-Myun

AU - Amar, Azali H.

AU - Kim, Seon Hahn

PY - 2011/9/1

Y1 - 2011/9/1

N2 - Background 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. Methods 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. Results 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/m2 (range, 17.9-32.5 kg/m2). 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. Conclusion Robot-assisted intersphincteric resection for very low rectal cancer is feasible, and its short-termoutcome is acceptable.

AB - Background 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. Methods 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. Results 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/m2 (range, 17.9-32.5 kg/m2). 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. Conclusion Robot-assisted intersphincteric resection for very low rectal cancer is feasible, and its short-termoutcome is acceptable.

KW - Cancer

KW - Intersphincteric

KW - Rectal

KW - Robot

UR - http://www.scopus.com/inward/record.url?scp=80055089421&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80055089421&partnerID=8YFLogxK

U2 - 10.1007/s00464-011-1657-6

DO - 10.1007/s00464-011-1657-6

M3 - Article

VL - 25

SP - 2987

EP - 2992

JO - Surgical Endoscopy

JF - Surgical Endoscopy

SN - 0930-2794

IS - 9

ER -