AIM To analyses the current literature regarding the urogenital functional outcomes of patients receiving robotic rectal cancer surgery. METHODS A comprehensive literature search of electronic databases was performed ...AIM To analyses the current literature regarding the urogenital functional outcomes of patients receiving robotic rectal cancer surgery. METHODS A comprehensive literature search of electronic databases was performed in October 2015. The following search terms were applied: "rectal cancer" or "colorectal cancer" and robot* or "da Vinci" and sexual or urolog* or urinary or erect* or ejaculat* or impot* or incontinence. All original studies examining the urological and/or sexual outcomes of male and/or female patients receiving robotic rectal cancer surgery were included. Reference lists of all retrieved articles were manually searched for further relevant articles. Abstracts were independently searched by two authors. RESULTS Fifteen original studies fulfilled the inclusion criteria. A total of 1338 patients were included; 818 received robotic, 498 laparoscopic and 22 open rectal cancer surgery. Only 726(54%) patients had their urogenital function assessed via means of validated functional questionnaires. From the included studies, three found that robotic rectal cancer surgery leads to quicker recovery of male urological function and five of male sexual function as compared to laparoscopic surgery. It is unclear whether robotic surgery offers favourable urogenital outcomes in the long run for males. In female patients only two studies assessed urological and threesexual function independently to that of males. In these studies there was no difference identified between patients receiving robotic and laparoscopic rectal cancer surgery. However, in females the presented evidence was very limited making it impossible to draw any substantial conclusions. CONCLUSION There seems to be a trend towards earlier recovery of male urogenital function following robotic surgery. To evaluate this further, larger well designed studies are required.展开更多
Introduction:Robotic systems are designed to address the limitations of laparoscopic surgery,leading to a growing interest in robotic rectal surgery.However,certain technical limitations associated with the previous s...Introduction:Robotic systems are designed to address the limitations of laparoscopic surgery,leading to a growing interest in robotic rectal surgery.However,certain technical limitations associated with the previous systems(da Vinci S&Si)have arguably slowed down its wholesale adoption.The latest robotic platform,the da Vinci Xi,addresses these limitations.This study aims to examine the short-term surgical outcomes of 240 single-docking fully-robotic rectal cancer resections and compare the outcomes of cases performed with the da Vinci Xi vs Si systems.Materials and methods:All consecutive patients receiving robotic rectal cancer resections from three centres between 2013 and 2018 were identified from prospectively collated databases.The baseline characteristics and short-term surgical outcomes are presented and the da Vinci Xi vs Si system outcomes are analysed.Results:A total of 240 patients were identified(124 Si,116 Xi).Median operation-time and length-of-stay were 260 minutes and 6 days respectively.Conversion and 30-day mortality rates were 0.The da Vinci Si vs Xi system analysis shows that operation-time was lower in the Si group(230 vs 300 min,p=0.000)but length-of-stay,lymph node yield and circumferential resection margin favoured the Xi group(7 vs 5 days,p=0.010;17 vs 21,p=0.000;92.7%vs 99.1%,p=0.020).Conclusion:Single-docking fully-robotic rectal cancer surgery is safe,feasible and can lead to good shortterm outcomes,making it a good alternative to laparoscopic rectal cancer surgery.The new systems technological advances may result in better short-term outcomes but further larger scale observational studies are required if we are to reach such a conclusion.展开更多
文摘AIM To analyses the current literature regarding the urogenital functional outcomes of patients receiving robotic rectal cancer surgery. METHODS A comprehensive literature search of electronic databases was performed in October 2015. The following search terms were applied: "rectal cancer" or "colorectal cancer" and robot* or "da Vinci" and sexual or urolog* or urinary or erect* or ejaculat* or impot* or incontinence. All original studies examining the urological and/or sexual outcomes of male and/or female patients receiving robotic rectal cancer surgery were included. Reference lists of all retrieved articles were manually searched for further relevant articles. Abstracts were independently searched by two authors. RESULTS Fifteen original studies fulfilled the inclusion criteria. A total of 1338 patients were included; 818 received robotic, 498 laparoscopic and 22 open rectal cancer surgery. Only 726(54%) patients had their urogenital function assessed via means of validated functional questionnaires. From the included studies, three found that robotic rectal cancer surgery leads to quicker recovery of male urological function and five of male sexual function as compared to laparoscopic surgery. It is unclear whether robotic surgery offers favourable urogenital outcomes in the long run for males. In female patients only two studies assessed urological and threesexual function independently to that of males. In these studies there was no difference identified between patients receiving robotic and laparoscopic rectal cancer surgery. However, in females the presented evidence was very limited making it impossible to draw any substantial conclusions. CONCLUSION There seems to be a trend towards earlier recovery of male urogenital function following robotic surgery. To evaluate this further, larger well designed studies are required.
文摘Introduction:Robotic systems are designed to address the limitations of laparoscopic surgery,leading to a growing interest in robotic rectal surgery.However,certain technical limitations associated with the previous systems(da Vinci S&Si)have arguably slowed down its wholesale adoption.The latest robotic platform,the da Vinci Xi,addresses these limitations.This study aims to examine the short-term surgical outcomes of 240 single-docking fully-robotic rectal cancer resections and compare the outcomes of cases performed with the da Vinci Xi vs Si systems.Materials and methods:All consecutive patients receiving robotic rectal cancer resections from three centres between 2013 and 2018 were identified from prospectively collated databases.The baseline characteristics and short-term surgical outcomes are presented and the da Vinci Xi vs Si system outcomes are analysed.Results:A total of 240 patients were identified(124 Si,116 Xi).Median operation-time and length-of-stay were 260 minutes and 6 days respectively.Conversion and 30-day mortality rates were 0.The da Vinci Si vs Xi system analysis shows that operation-time was lower in the Si group(230 vs 300 min,p=0.000)but length-of-stay,lymph node yield and circumferential resection margin favoured the Xi group(7 vs 5 days,p=0.010;17 vs 21,p=0.000;92.7%vs 99.1%,p=0.020).Conclusion:Single-docking fully-robotic rectal cancer surgery is safe,feasible and can lead to good shortterm outcomes,making it a good alternative to laparoscopic rectal cancer surgery.The new systems technological advances may result in better short-term outcomes but further larger scale observational studies are required if we are to reach such a conclusion.
