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Gastrointestinal tumours, colorectal

3029 - Robot-assisted vs. Laparoscopic vs. Open Abdominoperineal Resections for Low Rectal Cancer: Short-term Outcomes of a Single-center Prospective Randomized Controlled Trial

Date

10 Sep 2017

Session

Gastrointestinal tumours, colorectal

Presenters

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

Author affiliations

  • General Surgery Department, Zhongshan Hospital, Fudan University, 200032 - Shanghai/CN
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Resources

Abstract 3029

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.

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