Robotic Total Mesorectal Excision for Rectal Cancer: A Series of 392 Cases and Mid-Term Outcomes from A Single Center in China

Bo Tang, Chao Zhang, Chuan Li, Jun Chen, Huaxing Luo, Dongzhu Zeng, Peiwu Yu

Robotic total mesorectal excision (RTME) for rectal cancer has recently been increasingly used; technical feasibility and short-term outcomes have been reported in detail. Few studies have presented clinical efficacy and mid-term outcomes for a large sample size. The aim of this study is to present oncologic efficacy and mid-term outcomes of robotic total mesorectal excision for rectal cancer and to provide our experiences regarding these surgically challenging issues. Three hundred ninety-two patients received RTME between March 2010 and June 2015. Patient characteristics, perioperative clinical results, complications, pathologic details, recurrence, and mid-term outcomes were evaluated. Duration of surgery ranged from 80 to 388 min (median 224 min). There were no deaths during surgery and no anesthesiology complications in our series. The conversion rate was 1.1% (4/392). The postoperative complication rate was 10.2%; anastomosis leakage was the most common complication with an incidence of 4.1% (16/392). The median blood loss was 67.5±34.3 (20-600). The mean postoperative hospital stay was 12.1±6.1 (6-64). Circumferential resection margins were negative in 387 out of 392 cases (98.7%). The mean number of harvested lymph nodes was 14.6. Two deaths occurred during 30-day mortality. At a mean follow-up of 24 months (range 3-66 months), there were 35 deaths. Our results suggest that RTME is technically feasible for rectal cancer and can yield good short- and mid-term oncologic outcomes.