Estudio prospectivo, aleatorizado: cirugía laparoscópica con asistencia robótica versus cirugía laparoscópica convencional en la resección del cáncer colorrectal / Prospective randomised study: robotic-assisted versus conventional laparoscopic surgery in colorectal cancer resection

Introducción La cirugía robótica está tomando protagonismo en los últimos años en el abordaje de la dolencia oncológica colorrectal. Sin embargo, no existen todavía estudios que muestren ventajas objetivas de este tipo de abordaje. Presentamos un estudio prospectivo, aleatorizado cuyo objetivo es comparar los resultados a corto plazo entre la cirugía robótica y la cirugía laparoscópica colorrectal. Material y método Entre enero de 2008 y enero de 2009, 56 pacientes diagnosticados de cáncer colorrectal fueron aleatorizados y asignados al grupo de cirugía robótica o laparoscópica. Se compararon la edad, el índice de masa corporal, la localización tumoral, las conversiones de cada grupo, las complicaciones intra- y postoperatorias y las características histológicas de las piezas obtenidas. Resultados No hubo diferencias significativas en la edad (p=0,055), el índice de masa corporal (p=0,12), o la localización tumoral (p=0,91). Sólo un paciente precisó ser transfundido en el grupo robótico y ninguno en el grupo laparoscópico. El porcentaje de conversiones fue idéntico en ambos grupos, sin embargo el tiempo de preparación y el tiempo operatorio sí fue significativamente mayor en los pacientes intervenidos mediante el dispositivo robótico (p=0,0001 y p=0,017 respectivamente). No existieron diferencias en cuanto al índice de complicaciones ni el porcentaje de reintervenciones (14,2% y 7,1%). La estancia media de los pacientes fue de 9,3±8,1 días en el grupo robótico y de 9,2±6,8 días en el laparoscópico (p=0,79). El margen distal de resección fue mayor en el espécimen obtenido mediante cirugía robótica (p=0,003) así como el número de ganglios obtenidos de la pieza (p=0,23) (AU)

Introduction: Robotic-assisted surgery is playing an increasingly important role in the last few years in the treatment of colorectal oncological disease. However, there are still no studies that objectively demonstrate the advantages of this type of surgery. We present a prospective randomised study in order to compare the short-term results between colorectal robotic surgery and laparoscopic surgery. Material and method: A total of 56 patients diagnosed with colorectal cancer between January2008 and January 2009, were randomised and assigned to the robotic or laparoscopic group. Age, body mass index, tumour location, conversions in each group, complications during and after surgery, and histological characteristics of the specimens obtained, were all compared. Results: There were no significant differences between age (P=.055), body mass index (P=.12),or tumour location (P=.91). Only one patient in the robotic group required a transfusion and none in the laparoscopic group. The percentage of conversions was the same in both groups, however, the preparation times and operating times were significantly longer in patients intervened using the robotic device (P=.0001 and P=.017, respectively). There were no differences as regards the rate of complications or in the percentage of re-interventions(14.2% and 7.1%). The mean hospital stay of the patients was 9.3 (8.1) days in the robotic group and 9.2 (6.8) days in the laparoscopic (P=.79). The distal resection margin was greater in the specimen obtained using robotic surgery (P =.003) as well as the number of lymphnodes obtained in the specimen (P =.23).Conclusion: Robotic colorectal was performed safely and effectively, and with similar clinical results (AU)

[Prospective randomised study: robotic-assisted versus conventional laparoscopic surgery in colorectal cancer resection]. / Estudio prospectivo, aleatorizado: cirugía laparoscópica con asistencia robótica versus cirugía laparoscópica convencional en la resección del cáncer colorrectal.

INTRODUCTION: Robotic-assisted surgery is playing an increasingly important role in the last few years in the treatment of colorectal oncological disease. However, there are still no studies that objectively demonstrate the advantages of this type of surgery. We present a prospective randomised study in order to compare the short-term results between colorectal robotic surgery and laparoscopic surgery. MATERIAL AND METHOD: A total of 56 patients diagnosed with colorectal cancer between January 2008 and January 2009, were randomised and assigned to the robotic or laparoscopic group. Age, body mass index, tumour location, conversions in each group, complications during and after surgery, and histological characteristics of the specimens obtained, were all compared. RESULTS: There were no significant differences between age (P=.055), body mass index (P=.12), or tumour location (P=.91). Only one patient in the robotic group required a transfusion and none in the laparoscopic group. The percentage of conversions was the same in both groups, however, the preparation times and operating times were significantly longer in patients intervened using the robotic device (P=.0001 and P=.017, respectively). There were no differences as regards the rate of complications or in the percentage of re-interventions (14.2% and 7.1%). The mean hospital stay of the patients was 9.3 (8.1) days in the robotic group and 9.2 (6.8) days in the laparoscopic (P=.79). The distal resection margin was greater in the specimen obtained using robotic surgery (P =.003) as well as the number of lymph nodes obtained in the specimen (P =.23). CONCLUSION: Robotic colorectal was performed safely and effectively, and with similar clinical results. International Trial Number for this study is: ISRCTN60866560.