Totally robotic vs hybrid abdominoperineal resection: A retrospective multicenter analysis
Introduction Laparoscopic abdominoperineal resection (APR) for low rectal cancers is technically demanding. Robotic assistance may be of help and can be hybrid (HAPR) or totally robotic (RAPR). The present study describes outcomes of robotic APR and compares both approaches. Material and methods A m...
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| Veröffentlicht in: | The international journal of medical robotics + computer assisted surgery 2020-04, Vol.16 (2), p.e2073-n/a |
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| container_title | The international journal of medical robotics + computer assisted surgery |
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| creator | Douissard, Jonathan Obias, Vincent Johnson, Craig S Hagen, Monika E Keller, Deborah Ouellette, James R Hellan, Minia |
| description | Introduction
Laparoscopic abdominoperineal resection (APR) for low rectal cancers is technically demanding. Robotic assistance may be of help and can be hybrid (HAPR) or totally robotic (RAPR). The present study describes outcomes of robotic APR and compares both approaches.
Material and methods
A multicentric retrospective analysis of rectal cancer patients undergoing either HAPR or RAPR was conducted. Patients' demographics, surgeons' experience, oncologic results, and intraoperative and postoperative outcomes were collected.
Results
One hundred twenty‐five patients were included, 48 in HAPR group and 77 in RAPR group. Demographics and comorbidities were comparable. Operative time was reduced in RAPR group (266.9 ± 107.8 min vs 318.9 ± 75.1 min, P = .001). RAPR patients were discharged home more frequently (91.18% vs 66.67%, P = .001), and experienced fewer parastomal hernias (3.71% vs 9.86%, P = .001).
Conclusion
RAPR is safe and feasible with appropriate oncologic outcomes. Totally robotic approach reduces operative time and may improve functional outcomes. |
| doi_str_mv | 10.1002/rcs.2073 |
| format | Article |
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Laparoscopic abdominoperineal resection (APR) for low rectal cancers is technically demanding. Robotic assistance may be of help and can be hybrid (HAPR) or totally robotic (RAPR). The present study describes outcomes of robotic APR and compares both approaches.
Material and methods
A multicentric retrospective analysis of rectal cancer patients undergoing either HAPR or RAPR was conducted. Patients' demographics, surgeons' experience, oncologic results, and intraoperative and postoperative outcomes were collected.
Results
One hundred twenty‐five patients were included, 48 in HAPR group and 77 in RAPR group. Demographics and comorbidities were comparable. Operative time was reduced in RAPR group (266.9 ± 107.8 min vs 318.9 ± 75.1 min, P = .001). RAPR patients were discharged home more frequently (91.18% vs 66.67%, P = .001), and experienced fewer parastomal hernias (3.71% vs 9.86%, P = .001).
Conclusion
RAPR is safe and feasible with appropriate oncologic outcomes. Totally robotic approach reduces operative time and may improve functional outcomes.</description><identifier>ISSN: 1478-5951</identifier><identifier>EISSN: 1478-596X</identifier><identifier>DOI: 10.1002/rcs.2073</identifier><identifier>PMID: 31876089</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Inc</publisher><subject>abdominoperineal excision ; abdominoperineal resection ; Aged ; Colorectal cancer ; Equipment Design ; Female ; Humans ; Intraoperative Period ; Laparoscopy - instrumentation ; Laparoscopy - methods ; Male ; Middle Aged ; Operative Time ; Postoperative Complications ; Postoperative Period ; Proctectomy - instrumentation ; Proctectomy - methods ; rectal cancer ; Rectal Neoplasms - surgery ; rectal surgery ; Retrospective Studies ; robotic surgery ; Robotic Surgical Procedures - instrumentation ; Robotic Surgical Procedures - methods ; Robotics ; Treatment Outcome ; United States</subject><ispartof>The international journal of medical robotics + computer assisted surgery, 2020-04, Vol.16 (2), p.e2073-n/a</ispartof><rights>2019 John Wiley & Sons, Ltd</rights><rights>2019 John Wiley & Sons, Ltd.</rights><rights>2020 John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3493-62157190aaae62c17f69102cd2db0722454485ab4af31dccba692a9013972f733</citedby><cites>FETCH-LOGICAL-c3493-62157190aaae62c17f69102cd2db0722454485ab4af31dccba692a9013972f733</cites><orcidid>0000-0003-0158-1559 ; 0000-0002-3931-3157</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Frcs.2073$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Frcs.2073$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31876089$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Douissard, Jonathan</creatorcontrib><creatorcontrib>Obias, Vincent</creatorcontrib><creatorcontrib>Johnson, Craig S</creatorcontrib><creatorcontrib>Hagen, Monika E</creatorcontrib><creatorcontrib>Keller, Deborah</creatorcontrib><creatorcontrib>Ouellette, James R</creatorcontrib><creatorcontrib>Hellan, Minia</creatorcontrib><title>Totally robotic vs hybrid abdominoperineal resection: A retrospective multicenter analysis</title><title>The international journal of medical robotics + computer assisted surgery</title><addtitle>Int J Med Robot</addtitle><description>Introduction
Laparoscopic abdominoperineal resection (APR) for low rectal cancers is technically demanding. Robotic assistance may be of help and can be hybrid (HAPR) or totally robotic (RAPR). The present study describes outcomes of robotic APR and compares both approaches.
Material and methods
A multicentric retrospective analysis of rectal cancer patients undergoing either HAPR or RAPR was conducted. Patients' demographics, surgeons' experience, oncologic results, and intraoperative and postoperative outcomes were collected.
Results
One hundred twenty‐five patients were included, 48 in HAPR group and 77 in RAPR group. Demographics and comorbidities were comparable. Operative time was reduced in RAPR group (266.9 ± 107.8 min vs 318.9 ± 75.1 min, P = .001). RAPR patients were discharged home more frequently (91.18% vs 66.67%, P = .001), and experienced fewer parastomal hernias (3.71% vs 9.86%, P = .001).
Conclusion
RAPR is safe and feasible with appropriate oncologic outcomes. Totally robotic approach reduces operative time and may improve functional outcomes.</description><subject>abdominoperineal excision</subject><subject>abdominoperineal resection</subject><subject>Aged</subject><subject>Colorectal cancer</subject><subject>Equipment Design</subject><subject>Female</subject><subject>Humans</subject><subject>Intraoperative Period</subject><subject>Laparoscopy - instrumentation</subject><subject>Laparoscopy - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Operative Time</subject><subject>Postoperative Complications</subject><subject>Postoperative Period</subject><subject>Proctectomy - instrumentation</subject><subject>Proctectomy - methods</subject><subject>rectal cancer</subject><subject>Rectal Neoplasms - surgery</subject><subject>rectal surgery</subject><subject>Retrospective Studies</subject><subject>robotic surgery</subject><subject>Robotic Surgical Procedures - instrumentation</subject><subject>Robotic Surgical Procedures - methods</subject><subject>Robotics</subject><subject>Treatment Outcome</subject><subject>United States</subject><issn>1478-5951</issn><issn>1478-596X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kFtLwzAYhoMobk7BXyAFb7zpzKlN490YnmAg6ATxJqRpihlpM5N20n9v66aC4NWXLzx5ePMCcIrgFEGIL70KUwwZ2QNjRFkWJzx92f85J2gEjkJYQUgTmtJDMCIoYynM-Bi8Ll0jre0i73LXGBVtQvTW5d4UkcwLV5narbU3tZY28jpo1RhXX0Wzfmm8C-vhYqOjqrX9Y1032keylrYLJhyDg1LaoE92cwKeb66X87t48XB7P58tYkUoJ3GKUcIQh1JKnWKFWJlyBLEqcJFDhnGfmWaJzKksCSqUymXKseQQEc5wyQiZgIutd-3de6tDIyoTlLZW1tq1QWBCIOMkhQN6_gddudb3eQcqo5ATTNivUPU_DF6XYu1NJX0nEBRD36LvWwx99-jZTtjmlS5-wO-CeyDeAh_G6u5fkXicP30JPwFV3Ilj</recordid><startdate>202004</startdate><enddate>202004</enddate><creator>Douissard, Jonathan</creator><creator>Obias, Vincent</creator><creator>Johnson, Craig S</creator><creator>Hagen, Monika E</creator><creator>Keller, Deborah</creator><creator>Ouellette, James R</creator><creator>Hellan, Minia</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7SC</scope><scope>7SP</scope><scope>7TB</scope><scope>8FD</scope><scope>F28</scope><scope>FR3</scope><scope>JQ2</scope><scope>K9.</scope><scope>L7M</scope><scope>L~C</scope><scope>L~D</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0158-1559</orcidid><orcidid>https://orcid.org/0000-0002-3931-3157</orcidid></search><sort><creationdate>202004</creationdate><title>Totally robotic vs hybrid abdominoperineal resection: A retrospective multicenter analysis</title><author>Douissard, Jonathan ; Obias, Vincent ; Johnson, Craig S ; Hagen, Monika E ; Keller, Deborah ; Ouellette, James R ; Hellan, Minia</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3493-62157190aaae62c17f69102cd2db0722454485ab4af31dccba692a9013972f733</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>abdominoperineal excision</topic><topic>abdominoperineal resection</topic><topic>Aged</topic><topic>Colorectal cancer</topic><topic>Equipment Design</topic><topic>Female</topic><topic>Humans</topic><topic>Intraoperative Period</topic><topic>Laparoscopy - instrumentation</topic><topic>Laparoscopy - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Operative Time</topic><topic>Postoperative Complications</topic><topic>Postoperative Period</topic><topic>Proctectomy - instrumentation</topic><topic>Proctectomy - methods</topic><topic>rectal cancer</topic><topic>Rectal Neoplasms - surgery</topic><topic>rectal surgery</topic><topic>Retrospective Studies</topic><topic>robotic surgery</topic><topic>Robotic Surgical Procedures - instrumentation</topic><topic>Robotic Surgical Procedures - methods</topic><topic>Robotics</topic><topic>Treatment Outcome</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Douissard, Jonathan</creatorcontrib><creatorcontrib>Obias, Vincent</creatorcontrib><creatorcontrib>Johnson, Craig S</creatorcontrib><creatorcontrib>Hagen, Monika E</creatorcontrib><creatorcontrib>Keller, Deborah</creatorcontrib><creatorcontrib>Ouellette, James R</creatorcontrib><creatorcontrib>Hellan, Minia</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Computer and Information Systems Abstracts</collection><collection>Electronics & Communications Abstracts</collection><collection>Mechanical & Transportation Engineering Abstracts</collection><collection>Technology Research Database</collection><collection>ANTE: Abstracts in New Technology & Engineering</collection><collection>Engineering Research Database</collection><collection>ProQuest Computer Science Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Advanced Technologies Database with Aerospace</collection><collection>Computer and Information Systems Abstracts Academic</collection><collection>Computer and Information Systems Abstracts Professional</collection><collection>MEDLINE - Academic</collection><jtitle>The international journal of medical robotics + computer assisted surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Douissard, Jonathan</au><au>Obias, Vincent</au><au>Johnson, Craig S</au><au>Hagen, Monika E</au><au>Keller, Deborah</au><au>Ouellette, James R</au><au>Hellan, Minia</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Totally robotic vs hybrid abdominoperineal resection: A retrospective multicenter analysis</atitle><jtitle>The international journal of medical robotics + computer assisted surgery</jtitle><addtitle>Int J Med Robot</addtitle><date>2020-04</date><risdate>2020</risdate><volume>16</volume><issue>2</issue><spage>e2073</spage><epage>n/a</epage><pages>e2073-n/a</pages><issn>1478-5951</issn><eissn>1478-596X</eissn><abstract>Introduction
Laparoscopic abdominoperineal resection (APR) for low rectal cancers is technically demanding. Robotic assistance may be of help and can be hybrid (HAPR) or totally robotic (RAPR). The present study describes outcomes of robotic APR and compares both approaches.
Material and methods
A multicentric retrospective analysis of rectal cancer patients undergoing either HAPR or RAPR was conducted. Patients' demographics, surgeons' experience, oncologic results, and intraoperative and postoperative outcomes were collected.
Results
One hundred twenty‐five patients were included, 48 in HAPR group and 77 in RAPR group. Demographics and comorbidities were comparable. Operative time was reduced in RAPR group (266.9 ± 107.8 min vs 318.9 ± 75.1 min, P = .001). RAPR patients were discharged home more frequently (91.18% vs 66.67%, P = .001), and experienced fewer parastomal hernias (3.71% vs 9.86%, P = .001).
Conclusion
RAPR is safe and feasible with appropriate oncologic outcomes. Totally robotic approach reduces operative time and may improve functional outcomes.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Inc</pub><pmid>31876089</pmid><doi>10.1002/rcs.2073</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-0158-1559</orcidid><orcidid>https://orcid.org/0000-0002-3931-3157</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | abdominoperineal excision abdominoperineal resection Aged Colorectal cancer Equipment Design Female Humans Intraoperative Period Laparoscopy - instrumentation Laparoscopy - methods Male Middle Aged Operative Time Postoperative Complications Postoperative Period Proctectomy - instrumentation Proctectomy - methods rectal cancer Rectal Neoplasms - surgery rectal surgery Retrospective Studies robotic surgery Robotic Surgical Procedures - instrumentation Robotic Surgical Procedures - methods Robotics Treatment Outcome United States |
| title | Totally robotic vs hybrid abdominoperineal resection: A retrospective multicenter analysis |
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