Total mesorectal excision (TME) is a standard surgical procedure for rectal cancer. Robotic surgery has the potential to minimize the disadvantages of laparoscopic rectal resection. Circumferential margin and macroscopic quality assessment of the resected specimen are the major prognostic factors for local recurrence of the disease. The aim of this study was to research the macroscopic assessment of the quality of TME after robotic-assisted rectal resections for rectal cancer performed in a single center. Data was prospectively collected about macroscopic assessment of the quality of TME in thirteen patients after robotic-assisted rectal resections for rectal cancer between 09.04.2014 and 31.12.2016. After all robotic TMEs, a pathologist made macroscopic assessment of the completeness of the mesorectal excision. The quality of TME was complete in 12 cases and nearly complete in one case. The circumferential and distal resection margins were negative in all cases. The mean number of harvested lymph nodes was nine. This study indicated that using robotic surgery for rectal cancer does not lead to worsening the quality of TME. Further studies in this field are necessary.
If the inline PDF is not rendering correctly, you can download the PDF file here.
1. MacFarlane JK Ryall RD Heald RJ. Mesorectal excision for rectal cancer. Lancet. 1993;341(8843):457-60.
2. Carlsen E Schlichting E Guldvog I Johnson E Heald RJ. Effect of the introduction of total mesorectal excision for the treatment of rectal cancer. Br J Surg. 1998;85(4):526-9.
3. Van der Pas MH Haglind E Cuesta MA Fürst A Lacy AM Hop WC et al. Colorectal cancer Laparoscopic or Open Resection II (COLOR II) Study Group. Laparoscopic versus open surgery for rectal cancer (COLOR II): short-term outcomes of a randomised phase 3 trial. Lancet Oncol. 2013;14(3):210-8.
4. Anderson C Uman G Pigazzi A. Oncologic outcomes of laparoscopic surgery for rectal cancer: a systematic review and meta- analysis of the literature. Eur J Surg Oncol. 2008;34(10):1135-42.
5. Romano G Gagliardi G Bianco F Parker M C Corcione F. Laparoscopic colorectal surgery: why it is still not the gold standard and why it should be. Tech Coloproctol. 2008;12(2):185-8.
6. Shin DW Shin JY Oh SJ Park JK Yu H Ahn MS et al. The prognostic value of circumferential resection margin involvement in patients with extraperitoneal rectal cancer. Am Surg. 2016;82(4):348-355.
7. Nagtegaal ID Quirke P. What is the role for the circumferential margin in the modern treatment of rectal cancer? J Clin Oncol. 2008;26(2):303- 12.
8. Jayne D Pigazzi A Marshal H Croft J Corrigan N Copeland J et al. Effect of Robotic-Assisted vs Conventional Laparoscopic Surgery on Risk of Conversion to Open Laparotomy Among Patients Undergoing Resection for Rectal Cancer: The ROLARR Randomized Clinical Trial. JAMA. 2017;318(16):1569-80.
9. Campa-Thompson M Weir R Calcetera N Quirke P Carmack S. Pathologic processing of the total mesorectal excision. Clin Colon Rectal Surg. 2015;28(01):43-52.
10. Langer D Tučková I Kalvach J Ryska M. Can robotic rectal cancer surgery improve quality of total mesorectal excision? Rozhl Chir. 2017;96(2):69.