Robotically Performed Total Mesorectal Excision for Rectal Cancer
L. Alecu, O. Stănciulea, D. Poesina , V. Tomulescu, C. Vasilescu, I. PopescuOriginal article, no. 2, 2015
Background: Rectal cancer is an important health problem, dueto the increasing number of new cases and the quality of lifeissues brought forth by surgical treatment in these patients.Aim: The aim of the study was to analyse the results of roboticsurgery in the treatment of lower and middle rectal cancer,locations in which TME is performed.Material and Method: Patients diagnosed with and operated onfor rectal cancer by the means of robotic surgery between 2008-2012 at the Fundeni Clinical Institute were retrospectivelyanalysed.Results: A number of 117 patients with rectal cancer wereoperated on by robotic surgery, of which 79 (67.52%) weresubmitted to total mesorectal excision (TME). The most frequentlyperformed surgery was low anterior resection, followedby rectal amputation through abdominoperineal approach.Anastomosis fistula was observed in 9 (11.39%) patients. Localrecurrence was encountered in 2 (2.53%) of the roboticallyperformed surgeries.Conclusions: 1. Robotically assisted total mesorectal excision isfeasible, safe and can be performed with a small number ofcomplications and a low local recurrence rate; 2. The mainadvantages are oncological safety and quality of life; 3.Conversion to open surgery is rarely encountered; 4. Protectionloop ileostomy existence allows avoiding reintervention in case anastomotic fistula occurs in patients with low anteriorresection. 5. Robotic surgery may become gold standard in thesurgical treatment of rectal cancer.
