한빛사논문
- 조회229
Park, Jun Seok MD, PhD*; Lee, Sung Min MD*; Choi, Gyu-Seog MD, PhD*; Park, Soo Yeun MD*; Kim, Hye Jin MD*; Song, Seung Ho MD*; Min, Byung Soh MD, PhD†; Kim, Nam Kyu MD, PhD†; Kim, Seon-Han MD, PhD‡
*Colorectal Cancer Center, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
†Division of Colon and Rectal Surgery, Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
‡Division of Colorectal Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
Corresponding author: Choi, Gyu-Seog MD, PhD
Abstract
Objective: To evaluate whether robotic for middle or low rectal cancer produces an improvement in surgical outcomes compared with laparoscopic surgery in a randomized controlled trial (RCT).
Summary of background data: There is a lack of proven clinical benefit of robotic TME compared with a laparoscopic approach in the setting of multicenter RCTs.
Methods: Between July 2011 and February 2016, patients diagnosed with an adenocarcinoma located <10 cm from the anal verge and clinically rated T1-4aNxM0 were enrolled. The primary outcome was the completeness of TME assessed by a surgeon and a pathologist.
Results: The RCT was terminated prematurely because of poor accrual of data. In all, 295 patients were assigned randomly to a robot-assisted TME group (151 in R-TME) or a laparoscopy-assisted TME group (144 in L-TME). The rates of complete TME were not different between groups (80.7% in R-TME, 77.1% in L-TME). Pathologic outcomes including the circumferential resection margin (CRM) and the numbers of retrieved lymph nodes were not different between groups. In a subanalysis, the positive CRM rate was lower in the R-TME group (0% vs. 6.1% for L-TME; P=0.031). Among the recovery parameters, the length of opioid use was shorter in the R-TME group (P=0.028). There was no difference in the postoperative complication rate between the groups (12.0% for R-TME vs. 8.3% for L-TME).
Conclusions: In patients with middle or low rectal cancer, robotic-assisted surgery did not significantly improve the TME quality compared with conventional laparoscopic surgery (ClinicalTrial.gov ID: NCT01042743).
논문정보
- Research article
- 2023년 01월 (BRIC 등록일 2023-03-27)
- 국내 연구진
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