Clinical ScienceLaparoscopic versus robotic rectal resection for rectal cancer in a veteran population
Section snippets
Database and sample population
The Michael E. DeBakey VA Medical Center (MEDVAMC) Colorectal Cancer Database—our institutional review board–approved database—was used exclusively for this study. This database, which is routinely updated by research personnel using the MEDVAMC electronic medical record, contains demographic, clinical, pathologic, and postoperative follow-up data for all patients with colorectal cancer who have been seen in the MEDVAMC surgical oncology clinic. All data used in the study were derived from the
Baseline characteristics of sample population
In all, 72 patients underwent minimally invasive rectal resection for rectal cancer; 59 had LRR and 13 had RRR. Characteristics of the entire study population are presented in Table 1. The mean age of the entire cohort was 65.4 ± 1.4 years, almost all patients (97%) were male, and the majority (71%) were white. The mean BMI was 28.4 ± 6.1 kg/m2, indicating an overweight population.
As expected from a VA population, most patients had extensive comorbidities, with 89% presenting with an ASA class
Comments
Open surgery continues to be the current standard of care for colorectal resections. However, minimally invasive laparoscopic colon resection is now an accepted alternative for colon cancer and has been associated with reduced postoperative morbidity, improved quality of life, and equivalent oncologic outcomes in several studies.2, 3, 4, 22 As a result, laparoscopic colon resection may become the standard of care for the surgical treatment of colon cancer in the near future.
The role of
Conclusions
Given our findings, within the context of the available literature, we can conclude that robotic rectal resections can be safely performed even in a high-risk population such as ours and that the surgical robot can increase the application of minimally invasive surgery to even the most difficult rectal cancer cases. With increasing familiarity and training of OR personnel, the few drawbacks of robotic rectal surgery, which are all related to efficiency, will be diminished. With forthcoming
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The authors declare no conflicts of interest.
This manuscript has been reviewed and approved by all authors. The study has not been previously published.