A recent clinical trial comparing robotic and laparoscopic approaches provides valuable data on their long-term outcomes.
The findings emphasise the potential benefits of robotic surgery in enhancing patient survival rates and postoperative functional outcomes, highlighting its growing role in surgical practice.
Colorectal cancer is the third most common cancer in the world and the second leading cause of cancer-related death.
Researchers set out to compare robotic and laparoscopic surgery for rectal cancer, focusing on their long-term oncological outcomes.
Robotic surgery for rectal cancer is prevalent. Its 3D vision, stable camera platform, and flexible robotic arms help address the limitations of laparoscopic surgery, potentially enhancing surgical quality.
Laparoscopic surgery for rectal cancer has been widely accepted due to its minimal trauma, fast recovery and comparable long-term survival rates to open surgery.
However, its oncological outcomes remain contentious, with some studies showing higher rates of incomplete meso-rectal excision and positive circumferential resection margins compared to open surgery.
In a multicentre, randomised clinical trial conducted across 11 centres in China from July 2016 to December 2020, 1,240 eligible patients with middle or low rectal adenocarcinoma and no distant metastasis were assigned to either robotic or laparoscopic surgery. The follow-up continued until 31 December 2023.
The results showed that robotic surgery significantly enhanced long-term oncological outcomes. Specifically, the three-year loco-regional recurrence rate was considerably lower in the robotic group, which also experienced higher three-year disease-free survival rates.
Additionally, patients in the robotic group experienced better urinary and sexual functions, as well as improved defecation, compared to those undergoing laparoscopic surgery.
The authors conclude: ‘Compared with conventional laparoscopic surgery, robotic surgery significantly improved long-term oncological outcomes in patients with middle or low rectal cancer. With additional real-world clinical data and modern, improved training programmes for surgeons, robotic surgery could be the preferred choice for patients with middle or low rectal cancer.’
