482PD - Robot-assisted vs. Laparoscopic vs. Open Abdominoperineal Resections for Low Rectal Cancer: Short-term Outcomes of a Single-center Prospective Rand...

Date 10 September 2017
Event ESMO 2017 Congress
Session Gastrointestinal tumours, colorectal
Topics Rectal Cancer
Gastrointestinal Cancers
Surgery and/or Radiotherapy of Cancer
Presenter Jianmin Xu
Citation Annals of Oncology (2017) 28 (suppl_5): v158-v208. 10.1093/annonc/mdx393
Authors J. Xu, Y. Wei, L. Ren, Q. Feng, J. Chen, D. Zhu, W. Chang, T. Yi, L. Yang, X. Qin
  • General Surgery Department, Zhongshan Hospital, Fudan University, 200032 - Shanghai/CN

Abstract

Background

Currently, robotic surgery for rectal cancer using da Vinci System is common. However, there is almost no clinical trial reported. This randomized controlled trial aims to compare the safety and efficacy of robot-assisted, laparoscopic and open abdominoperineal resection (APR) for low rectal cancer.

Methods

From 2013-09 to 2017-03, patients aged from 18 to 75 years, with low rectal cancer within 5 cm from anal verge, clinical T1 to T3, no distant metastases, were randomly assigned to receive either robot-assisted procedures (RAP), laparoscopic procedures (LAP) or open surgery (OS) for APR in 1:1:1 ratio. The primary endpoint was postoperative complication rate.

Results

Totally 506 patients were enrolled in this study, randomly assigned to RAP (n = 169), LAP (n = 169), and OS (n = 168). Actually, 3 patients refused surgery, 173 finished RAP, 176 finished LAP, and 154 finished OS (including 4 convert from LAP to OS). The open conversion rate was 0 in RAP and 2.4% in LAP, with no significant difference (P = 0.123). In per-protocol analysis, no significant difference was observed in tumor location, size, differentiation and pathological TNM stage, among the three groups. RAP had significantly lower postoperative complication rate (10.4%) than both LAP (18.8%, P = 0.027) and OS (26.0%, P 

Conclusions

Robot-assisted APR was safe, and reproduce equivalent surgical quality of conventional laparoscopic and open surgery. Also, it provided less injury and faster functional recovery.

Clinical trial identification

NCT01985698.

Legal entity responsible for the study

Jianmin Xu

Funding

None

Disclosure

All authors have declared no conflicts of interest.