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Robot-assisted lateral pelvic lymph node dissection in patients with advanced rectal cancer: a single-center experience of 65 cases

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Abstract
The treatment of lateral pelvic lymph node (LPLN) metastasis of rectal cancer has evolved because of technical difficulties from open surgery to laparoscopy and, recently, robot-assisted surgery. This study aimed to evaluate the technical feasibility and short- and long-term outcomes of robot-assisted LPLN dissection (LPND) following total mesorectal excision (TME) in advanced rectal cancer. Clinical data of 65 patients who underwent robotic-assisted TME with LPND from April 2014 to July 2022 were reviewed. Data regarding operative details, postoperative morbidity (within 90 postoperative days) for short-term outcomes and lateral recurrence as long-term outcomes were analyzed. Among the 65 patients with LPND, preoperative chemoradiotherapy was performed in 49 (75.4%). The mean operative time was 306.8 (range 191-477) min, and the mean time of unilateral LPND was 38.6 (range 16-66) min. LPND was bilaterally performed in 19 (29.2%) patients. The mean number of each side of harvested LPLNs was 6.8. Lymph node metastasis was observed in 15 (23.0%) patients, and 10 (15.4%) patients had postoperative complications. Lymphocele (n = 3) and pelvic abscess (n = 3) were the most common, followed by voiding difficulty, erectile dysfunction, obturator neuropathy, and sciatic neuropathy (all n = 1). During the 25 months of median follow-up, no lateral recurrence of the LPND site was noted. Robot-assisted LPND following TME is safe and feasible and showed acceptable short- and long-term outcomes. Despite some study limitations, we may be able to apply this strategy more widely through subsequent prospective controlled studies.
Issued Date
2023
Eon Bin Kim
Yong Sik Yoon
Min Hyun Kim
Young Il Kim
Jong Lyul Lee
Chan Wook Kim
In Ja Park
Seok-Byung Lim
Chang Sik Yu
Jin Cheon Kim
Type
Article
Keyword
FeasibilityLateral pelvic lymph nodeRectal cancerRobot-assisted surgery
DOI
10.1007/s11701-023-01570-6
URI
https://oak.ulsan.ac.kr/handle/2021.oak/17142
Publisher
Journal of Robotic Surgery
Language
영어
ISSN
1863-2483
Citation Volume
17
Citation Number
4
Citation Start Page
1697
Citation End Page
1703
Appears in Collections:
Medicine > Nursing
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