Robotic surgery contributes to the preservation of bowel and urinary function after total mesorectal excision: comparisons with transanal and conventional laparoscopic surgery

Miura, Takuya; Sakamoto, Yoshiyuki; Morohashi, Hajime; Suto, Akiko; Kubota, Shunsuke; Ichisawa, Aika; Kuwata, Daisuke; Yamada, Takahiro; Tamba, Hiroaki; Matsumoto, Shuntaro; Hakamada, Kenichi

doi:10.1186/s12893-022-01596-x

Table 2 Clinicopathological and preoperative functional comparisons between robotic and transanal or laparoscopic approach

From: Robotic surgery contributes to the preservation of bowel and urinary function after total mesorectal excision: comparisons with transanal and conventional laparoscopic surgery

Variables	Robot	taTME	P value*	Laparoscopy	P value**
Variables	N = 35	N = 15	P value*	N = 14	P value**
Age^†	65 (37–75)	70 (38–81)	0.03	66 (34–77)	0.65
Gender (male), n (%)	28 (80.0)	14 (93.3)	0.40	8 (57.1)	0.15
Body mass index (kg/m²)^†	23.0 (18.7–31.4)	23.3 (19.1–28.9)	0.97	21.4 (18.6–28.8)	0.29
Smoking, n (%)	9 (25.7)	5 (33.3)	0.73	8 (57.1)	0.05
Hypertension, n (%)	13 (61.9)	8 (38.1)	0.35	4 (28.6)	0.74
Diabetes, n (%)	4 (11.4)	5 (33.3)	0.10	2 (14.3)	1.00
ASA ≥ 3, n (%)	2 (5.7)	0 (0)	1.00	1 (7.1)	1.00
Tumor size (mm)^†	34 (0–80)	38 (0–75)	0.96	37 (0–57)	0.85
Distance from AV to tumor (mm)^†	55 (25–80)	50 (30–60)	0.17	57 (35–80)	0.29
cT3, n (%)	22 (62.9)	7 (46.7)	0.35	10 (71.4)	0.74
cN positive, n (%)	14 (40.0)	2 (13.3)	0.09	7 (50.0)	0.54
Preoperative treatment, n (%)	21 (60.0)	7 (46.7)	0.53	8 (57.1)	1.00
Hand sewn, n (%)	12 (34.2)	15 (100)	< 0.01	5 (35.7)	1.00
Anastomotic height from AV (mm)^†	40 (20–60)	25 (20–40)	< 0.01	50 (20–60)	0.52
Lateral lymph node dissection, n (%)	21 (60.0)	7 (46.7)	0.53	4 (71.4)	0.52
Operation time (min)^†	465 (299–631)	317 (170–396)	< 0.01	430 (185–639)	0.39
Blood loss (ml)^†	50 (0–440)	60 (5–230)	0.33	107 (0–3137)	0.91
Clavien-Dindo ≥ 3, n (%)	1 (2.9)	2 (13.3)	0.21	3 (21.4)	0.06
Anastomotic leakage, n (%)	1 (2.9)	2 (13.3)	0.21	2 (14.3)	0.19
pStage 0-I, n (%)	23 (65.7)	12 (80.0)	0.50	4 (28.6)	0.02
Distal margin (mm)^†	15 (5–30)	20 (10–35)	0.02	20 (5–30)	0.19
Radial margin ≤ 1 mm, n (%)	0 (0)	1 (6.7)	0.30	2 (14.3)	0.07
Wexner score^†	1 (0–16)	2 (0–4)	0.55	1 (0–18)	0.55
Wexner ≥ 10, n (%)	1 (2.9)	0 (0)	1.00	1 (7.1)	0.49
LARS score^†	11 (0–39)	15 (0–38)	0.71	11 (0–41)	0.22
major LARS, n (%)	3 (8.6)	2 (13.3)	0.62	4 (28.6)	0.09
mFIQL score^†	0 (0–57.1)	0 (0–23.8)	0.88	0 (0–90.4)	0.90
mFIQL ≥ 50, n (%)	2 (5.7)	0 (0)	1.00	1 (7.1)	1.00
IPSS^†	5 (0–27)	7 (3–29)	0.06	5.5 (1–21)	0.66
Severe IPSS, n (%)	1 (2.9)	2 (13.3)	0.21	1 (7.1)	0.49
Observational periods (month)^†	22 (9–47)	43 (7–54)	< 0.01	33 (7–52)	0.01
Permanent stoma at 2 years, n (%)	1 (2.9)	6 (40.0)	< 0.01^¶	1 (7.1)	0.97^¶

ASA American Society of Anesthesiologists, AV anal verge, taTME transanal total mesorectal excision, LARS low anterior resection syndrome, mFIQL modified fecal incontinence quality of life, IPSS international prostate symptom score
^†Median (Range)
*Robotic vs Transanal; **Robotic vs Laparoscopic; ^¶Log-rank test

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