KEY TAKEAWAYS
- The study aimed to assess the feasibility and outcomes of robotic sphincter-preserving surgery for patients with rectal cancer having preexisting colostomy.
- Researchers noted that robotic surgery was safely performed with a stoma, despite longer console time.
Diverting colostomy followed by neoadjuvant treatment is a preferred approach for managing obstructive rectal cancer. Robotic surgery offers several advantages over conventional laparoscopic surgery, including enhanced precision and potentially improved outcomes.
However, the presence of an existing stoma can complicate the procedure by interfering with optimal trocar positioning, potentially affecting the quality of the surgery. Additionally, the console surgeon’s position, not facing the patient, could pose a risk to the stoma.
H Nozawa and the team aimed to assess the feasibility and outcomes of robotic sphincter-preserving surgery in rectal cancer patients with preexisting colostomy following neoadjuvant treatment.
They performed an inclusive analysis of patients with rectal cancer who underwent sphincter-preserving surgery using a robotic platform after receiving neoadjuvant treatment at the hospital. Patients were retrospectively divided into 2 groups based on the presence or absence of a pre-treatment stoma: the NS group (patients without a stoma) and the S group (patients with a stoma).
The study compared baseline characteristics, types of neoadjuvant treatment received, short-term surgical outcomes, postoperative anorectal manometric data, and survival outcomes between the 2 groups.
About 65 patients comprised the NS group, and 9 patients were in the S group. Conversion to laparotomy was required in three patients from the NS group. The S group had a longer console time compared to the NS group (median: 367 vs. 253 minutes, respectively, P=0.038); however, no significant difference was observed in total operative time (P=0.15) or blood loss (P=0.70). Postoperative complication rates, anorectal function, and oncological outcomes were found to be similar between the groups.
The study concluded that although console time was longer for patients with a stoma, robotic sphincter-preserving surgery after neoadjuvant treatment could be performed safely and effectively, with outcomes comparable to those in patients without a stoma.
The study received open-access funding from The University of Tokyo.
Source: https://pubmed.ncbi.nlm.nih.gov/39138696/
Nozawa H, Sakamoto A, Murono K, et al. (2024). “Feasibility and outcomes of robotic sphincter-preserving surgery for rectal cancer after neoadjuvant treatment in patients with preexisting colostomy.” Tech Coloproctol. 2024 Aug 13;28(1):102. doi: 10.1007/s10151-024-02980-w. PMID: 39138696.
