Table 2 Demographics and surgical outcomes of LSC and RAS rectal surgery. Abbreviations: LSC: laparoscopy; RAS: robotic assisted surgery; PSM: propensity score matching; ERAS: enhanced recovery after surgery; U/3: upper third; M/3: middle third; L/3: low third; RT: radiotherapy; LAR: low anterior resection; TME: total mesorectal excision; APR: abdominoperineal resection; CRM: circumferential margin.
From: Learning curve and surgical outcome of robotic assisted colorectal surgery with ERAS program
Rectal surgery | Original | PSM (gender, age, ASA, radiotherapy) | Robotic ERAS PSM | ||||||
|---|---|---|---|---|---|---|---|---|---|
LSC all (n = 46) | RAS all (n = 67) | pvalue | LSC (n = 32 ) | RAS (n = 32 ) | pvalue | Convention LSC (n = 27) | Robotic ERAS (n = 27) | pvalue | |
Gender | 0.635 | 0.796 | 0.406 | ||||||
Female | 15 (33%) | 26 (39%) | 11 (34%) | 13 (41%) | 9 (33%) | 13 (48%) | |||
Male | 31 (67%) | 41 (61%) | 21 (66%) | 19 (59%) | 18 (67%) | 14 (52%) | |||
Age | 65.0 (61.0–73.8) | 56.0 (47.0–68.0) | < 0.001** | 63.0 (59.5–70.5) | 65.5 (54.5–74.0) | 0.824 | 64.0 (62.0–71.0) | 67.0 (54.0–71.0) | 0.945 |
ASA | 0.063 | 1.000 | 1.000 | ||||||
1 + 2 | 29 (63%) | 54 (81%) | 24 (75%) | 24 (75%) | 19 (70%) | 20 (74%) | |||
3 | 17 (37%) | 13 (19%) | 8 (25%) | 8 (25%) | 8 (30%) | 7 (26%) | |||
BMI | 1.000 | 0.497 | 0.904 | ||||||
< 24.9 | 28 (62%) | 42 (64%) | 18 (56%) | 21 (68%) | 16 (59%) | 14 (54%) | |||
≥ 25 | 17 (38%) | 24 (36%) | 14 (44%) | 10 (32%) | 11 (41%) | 12 (46%) | |||
Disease | 0.714 | 1.000 | 1.000 | ||||||
Benign | 4 (9%) | 4 (6%) | 0 (0%) | 1 (3%) | 0 (0%) | 1 (4%) | |||
Malignant | 42 (91%) | 63 (94%) | 32 (100%) | 31 (97%) | 27 (100%) | 26 (96%) | |||
cT3 margin+ | 12 (29%) | 24 (38%) | 0.459 | 11 (34%) | 12 (38%) | 1.000 | 7 (26%) | 6 (22%) | 1.000 |
Lesion site | 0.448 | 0.608 | 0.782 | ||||||
U/3 | 17 (37%) | 19 (28%) | 11 (34%) | 14 (44%) | 10 (37%) | 12 (44%) | |||
M/3 + L/3 | 29 (63%) | 48 (72%) | 21 (66%) | 18 (56%) | 17 (63%) | 15 (56%) | |||
Pre-op RT | 0.006** | 1.000 | 0.524 | ||||||
No | 33 (79%) | 32 (50%) | 23 (72%) | 23 (72%) | 19 (70%) | 22 (81%) | |||
Yes | 9 (21%) | 32 (50%) | 9 (28%) | 9 (28%) | 8 (30%) | 5 (19%) | |||
Intention surgery | 0.914 | 0.695 | 0.757 | ||||||
LAR | 15 (33%) | 20 (30%) | 9 (29%) | 12 (38%) | 10 (37%) | 12 (44%) | |||
TME | 24 (53%) | 40 (60%) | 16 (52%) | 17 (53%) | 13 (48%) | 13 (48%) | |||
APR | 4 (9%) | 5 (7%) | 4 (13%) | 2 (6%) | 3 (11%) | 1 (4%) | |||
Others | 2 (4%) | 2 (3%) | 2 (6%) | 1 (3%) | 1 (4%) | 1 (4%) | |||
Combine surgery | 6 (13%) | 6 (9%) | 0.543 | 4 (13%) | 3 (9%) | 1.000 | 5 (19%) | 2 (7%) | 0.420 |
Surgeon | 0.339 | 0.708 | 0.669 | ||||||
A | 41 (89%) | 54 (81%) | 29 (91%) | 27 (84%) | 23 (85%) | 25 (93%) | |||
B | 5 (11%) | 13 (19%) | 3 (9%) | 5 (16%) | 4 (15%) | 2 (7%) | |||
ERAS | 4 (9%) | 54 (81%) | < 0.001** | 3 (9%) | 25 (78%) | < 0.001** | 0 (0%) | 27 (100%) | < 0.001** |
Operation time | |||||||||
Mean | 223.6 ± 64 | 345.3 ± 115 | < 0.001** | 225.9 ± 66 | 339.9 ± 108 | < 0.001** | 228.2 ± 66 | 317.8 ± 73 | < 0.001** |
Median | 210.0 (175.0–270.0) | 319.0 (273.0–360.0) | 210.0 (175.0–273.0) | 319.0 (264.5–366.7) | 210.0 (175.0–274.0) | 329.0 (259.0–360.0) | |||
Stoma+ | 22 (48%) | 52 (79%) | 0.001** | 17 (53%) | 23 (72%) | 0.197 | 14 (52%) | 18 (69%) | 0.311 |
Blood loss | |||||||||
Mean | 78.3 ± 77 | 82.7 ± 135 | 0.428 | 89.1 ± 86 | 62.8 ± 57 | 0.349 | 77.4 ± 75 | 44.1 ± 41 | 0.083 |
Median | 30.0 (30.0–112.5) | 30.0 (30.0–100.0) | 30.0 (30.0–150.0) | 30.0 (30.0–100.0) | 30.0 (30.0–150.0) | 30.0 (30.0–30.0) | |||
Open rate | 3 (7%) | 0 (0%) | 0.065 | 3 (9%) | 0 (0%) | 0.238 | 1 (4%) | 0 (0%) | 1.000 |
p stage | 0.689 | 0.690 | 0.558 | ||||||
0, 1 | 15 (36%) | 28 (43%) | 13 (41%) | 11 (34%) | 11 (41%) | 13 (48%) | |||
2, 3 | 24 (57%) | 34 (52%) | 17 (53%) | 20 (63%) | 13 (48%) | 13 (48%) | |||
4 | 3 (7%) | 3 (5%) | 2 (6%) | 1 (3%) | 3 (11%) | 1 (4%) | |||
CRM positive | 2 (4%) | 7 (10%) | 0.310 | 2 (6%) | 4 (13%) | 0.672 | 2 (7%) | 2 (7%) | 1.000 |
Distal margin involved | 3 (7%) | 0 (0%) | 0.065 | 2 (6%) | 0 (0%) | 0.492 | 2 (7%) | 0 (0%) | 0.491 |
Distal margin, mean | 2.2 ± 1.7 | 2.2 ± 2.1 | 0.965 | 2.1 ± 1.7 | 2.3 ± 1.9 | 0.585 | 2.2 ± 2.0 | 2.1 ± 1.4 | 0.676 |
Hospital stay | |||||||||
Mean | 10.9 ± 7.4 | 6.8 ± 5.7 | < 0.001** | 9.1 ± 6.4 | 6.3 ± 4.1 | < 0.001** | 10.1 ± 7.0 | 5.4 ± 3.5 | < 0.001** |
Median | 8.0 (6.0–13.3) | 5.0 (4.0–7.0) | 7.0 (6.0–8.0) | 5.0 (4.0–7.0) | 7.0 (6.0–11.0) | 4.0 (4.0–5.0) | |||
Complication | |||||||||
Minor | 17 (37%) | 8 (12%) | 0.004** | 9 (28%) | 4 (13%) | 0.214 | 9 (33%) | 3 (11%) | 0.102 |
Major | 3 (7%) | 7 (10%) | 0.524 | 2 (6%) | 3 (9%) | 1.000 | 2 (7%) | 2 (7%) | 1.000 |
Leakage rate | 1 (2%) | 5 (7%) | 0.398 | 0 (0%) | 2 (6%) | 0.492 | 0 (0%) | 2 (7%) | 0.491 |
