Abstract:Objective: To compare short-term outcomes between robotic-assisted and laparoscopic total mesorectal excision (TME) for rectal cancer. Methods: A total of 365 patients diagnosed with rectal cancer in Gansu Provincial Hospital from January 2017 to January 2020 were included in this study, among which 175 patients underwent robotic-assisted TME (R-TME group) and 190 patients underwent laparoscopic TME (L-TME group). The data of intra-operative, post-operative and clinical follow-up were compared between the two groups. Results: Compared to the L-TME group, the R-TME group had significantly less amount of bleeding [ (94.8±55.6) mL vs. (127.4±42.1) mL, t=-2.739, P=0.007], shorter first aerofluxus time [ (60.3±11.9) h vs. (78.8±12.3) h, t=-12.189, P=0.000], shorter first liquid diet time [ (89.0±15.0) h vs. (113.7±10.1) h, t=-13.597, P=0.000], shorter postoperative hospital stay [ (8.5±1.7) d vs. (10.2±2.4) d, t=-4.150, P=0.000], but more in-patient costs [ (83 538.1±10 911.0) vs. (70 640.4±11 659.0), t=6.338, P=0.000]. There were no significant differences between the two groups in operation time [ (202.9±14.7) min vs. (207.0±14.2) min, t=0.566, P=0.572], postoperative drainage time [ (5.9±1.4) d vs. (6.0±1.4) d, t=-0.516, P=0.557], and the volume of drainage [ (202.7±87.0) mL vs. (200.0±87.1) mL, t=0.335, P=0.738]. There was no significant difference in lymph node dissection, oncological results and overall postoperative complications between the two groups (P>0.05). The circumferential resection margin was negative in both groups. There was no death during the perioperative period. In terms of follow-up, 175 patients (16 lost) in the R-TME group were followed up for an average of 17.4 months, and 3 elderly patients t died of other basic diseases. In the L-TME group, 190 patients (23 lost) were followed up for an average of 16.9 months, and 6 elderly patients died of other basic diseases. No serious complications such as recurrence, incisional abdominal wall hernias and ostomy-related diseases occurred during the follow-up of the two groups. Conclusion: Compared with laparoscopic surgery, R-TME for rectal cancer with less bleeding and faster recovery of gastrointestinal function post operation, is safe, effective and worthy of clinical application.
