Short-term Outcomes Following Robotic-assisted Laparoscopic Surgery for Technically Demanding Rectal Cancer

Aim: To clarify the benefits of robotic-assisted laparoscopic surgery (RALS) regarding short-term outcomes in patients with technically demanding rectal cancer (TDRC). Patients and Methods: Between April 2015 and September 2019, 88 TDRC cases were identified from our database, and divided into the RALS (n=32) and conventional laparoscopic surgery (CLS) (n=56) groups. TDRC was defined as midrectal tumors presenting at least one of the following risk factors: Male sex, high body mass index, T4 stage, bulky tumor, or low rectal tumor. Results: Patient baseline characteristics were similar in both groups. One and 15 patients developed anastomotic leakage in the RALS and CLS groups (3% vs. 27%, p<0.01), respectively. The postoperative complication rate was lower in the RALS group (19% vs. 43%, p=0.03). Multivariate analysis showed the surgical approach to be an independent predictor for anastomotic leakage. Conclusion: RALS has potential advantages to prevent anastomotic leakage complications in patients with TDRC.