scholarly journals AB012. Robotic assisted ultra-low anterior resection with intersphincteric dissection post neoadjuvant chemoradiotherapy for rectal cancer

2019 ◽  
Vol 3 ◽  
pp. AB012-AB012
Author(s):  
Awais Aamir ◽  
Tara Connolly ◽  
Helen Mohan ◽  
Shoaib Ashfaq ◽  
Dara Walsh ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Neoadjuvant Chemoradiotherapy ◽  
Robotic Assisted ◽  
Intersphincteric Dissection

scholarly journals Comparison between robotic-assisted and laparoscopic sphincter-preserving operations for ultra-low rectal cancer: a single institutional retrospective study

2021 ◽  
Author(s):  
Tadahiro Kojima ◽  
Hitoshi Hino ◽  
Akio Shiomi ◽  
Hiroyasu Kagawa ◽  
Yusuke Yamaoka ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Multivariate Analyses ◽  
Anal Verge ◽  
Intersphincteric Resection ◽  
Low Rectal Cancer ◽  
Robotic Assisted ◽  
Robotic Assisted Surgery

Abstract Background Sphincter-preserving operations for ultra-low rectal cancer include low anterior resection and intersphincteric resection. In low anterior resection, the distal rectum is divided by a transabdominal approach, which is technically demanding. In intersphincteric resection, a perineal approach is performed. We aimed to evaluate whether robotic-assisted surgery is technically superior to laparoscopic surgery for ultra-low rectal cancer. The frequency of conducting low anterior resection by a specific procedure can indicate the technical superiority of that procedure for ultra-low rectal cancer. Thus, we compared the frequency of low anterior resection between robotic-assisted and laparoscopic surgery in cases of sphincter-preserving operations. Methods We investigated 183 patients who underwent sphincter-preserving robotic-assisted or laparoscopic surgery for ultra-low rectal cancer (lower border within 5 cm of the anal verge) between April 2010 and March 2020. The frequency of low anterior resection was compared between laparoscopic and robotic-assisted surgeries. The clinicopathological factors associated with an increase in performing low anterior resection were analyzed by multivariate analyses. Results Overall, 41 (22.4%) and 142 (77.6%) patients underwent laparoscopic and robotic-assisted surgery, respectively. Patient characteristics were similar between the groups. Low anterior resection was performed significantly more frequently in robotic-assisted surgery (67.6%) than in laparoscopic surgery (48.8%) (p = 0.04). Multivariate analyses showed that tumor distance from the anal verge (p < 0.01) and robotic-assisted surgery (p = 0.02) were significantly associated with an increase in the performance of low anterior resection. The rate of postoperative complications or pathological results was similar between the groups. Conclusions Compared with laparoscopic surgery, robotic-assisted surgery significantly increased the frequency of low anterior resection in sphincter-preserving operations for ultra-low rectal cancer. Robotic-assisted surgery has technical superiority over laparoscopic surgery for ultra-low rectal cancer treatment.

Neoadjuvant chemoradiotherapy for locally advanced low-lying rectal cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e15095-e15095
Author(s):  
B. Yu ◽  
M. Zhang ◽  
W. Wu ◽  
L. Chen ◽  
L. Peng ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Curative Resection ◽  
Tumor Regression ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Sphincter Preservation ◽  
Complete Regression ◽  
Local Recurrences

e15095 Objective: The aim of this trial was to explore the possibility of further improvement of efficacy in neoadjuvant chemoradiation for the treatment of locally advanced low-lying rectal cancer and the management of patients with clinical complete regression. Methods: 192 cases with locally advanced low-lying rectal cancer (T3/T4 or N+) received preoperative radiotherapy comprising 40–46 Gy/20–23 fractions and concomitant oral capecitabine 625 mg/m2 bid for 10 weeks prior to surgery. Curative resection with TME was carried out 6 weeks after the end of radiation. Results: Patients (pts) were recruited from May 2001 through August 2007. Overall, 117 pts (60.9%) experienced adverse events but only 2 suffered from grade 3 hand-foot syndrome. 17 pts (8.9%) had clinical complete tumor regression without surgery, 175 pts underwent curative resection including of 134 pts with low anterior resection (LAR), 32 pts with ultra-low anterior resection with Parks’ coloanal anastomosis and among them 6 pts with diverting temporary colostomy and 9 pts with APR. Sphincter preservation was achieved in 95.3%. Pathologically, 24 pts (12.5%) showed CR together with 17 pts with clinical CR; the overall CR rate was 21.4%. According to the pathological staging: T0N0 41 cases, T2N0 43 cases, T3N0 77 cases, T4N0 5 cases, T2N1 11 cases, T3N1 13 cases, T4N0 5 cases, and T4N1 2 cases; in semiquantitative Dworak's tumor regression grade, TRG0 8 pts,TRG1 32, TRG2 28,TRG3 83 and TRG4 41 with an overall tumor downstaging of 79.2%. There were no operative deaths, 5 pts suffered from rectovaginal fistulas and 4 anastomotic leakages with an overall anastomotic leakage rate of 5.1% (9/175) and all recovered without further events. All patients have been followed up for a median of 46 months (range 12–87). During the time, 11 pts had lung metastases, 6 liver metastases and 7 had local recurrences. The 3-year disease-free survival was 86.6% and overall survival was 92.6%. Conclusions: Neoadjuvant chemoradiotherapy has high efficacy resulting in tumor down-staging, increased resectability and sphincter preservation, and a reduction in local recurrences. Meanwhile those patients with clinical complete response can be followed up closely and safely without surgery. No significant financial relationships to disclose.

scholarly journals Pelvic intraoperative neuromonitoring during robotic-assisted low anterior resection for rectal cancer

2015 ◽  
Vol 10 (2) ◽  
pp. 157-160 ◽  
Author(s):  
Marian Grade ◽  
Alexander W. Beham ◽  
P. Schüler ◽  
Werner Kneist ◽  
B. Michael Ghadimi
Keyword(s):  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Intraoperative Neuromonitoring ◽  
Robotic Assisted

scholarly journals Treatment of Rectal Cancer by Low Anterior Resection with Coloanal Anastomosis

1994 ◽  
Vol 219 (4) ◽  
pp. 365-373 ◽  
Author(s):  
Philip B. Paty ◽  
Warren E. Enker ◽  
Alfred M. Cohen ◽  
Gregory Y. Lauwers
Keyword(s):  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Coloanal Anastomosis
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