Robotic versus Laparoscopic Intersphincteric Resection for Low Rectal Cancer: A Comparative Study of Short-term Outcomes

Results: There were no differences in demographic data including tumor location, which was 2.5±0.7cm from the anal verge in the laparoscopic group and 2.7±0.9 cm in the robotic group. Mean operation time was significantly longer in the robotic group compared with the laparoscopic group (278±65.3 minutes versus 225±66.9, p<0.001). With respect to histopathologic outcomes, patients with circumferential resection margin (CRM) less than 2 mm were observed more frequently in the laparoscopic group than in the robotic group (18.3% versus 5.9%, p=0.050). The rate of postoperative morbidity was lower in the robotic group than in the laparoscopic group (14.7% versus 35.0%, p=0.035). Patients in the robotic group showed a low Clavien-Dindo score more frequently than those in the laparoscopic group (p=0.049). Conclusion: Robotic ISR is a safe and feasible procedure associated with a lower rate of narrow CRM and postoperative morbidity in spite of a longer operation time, compared with the laparoscopic approach. Prospective clinical trials with larger numbers of cases evaluating long-term oncologic and functional outcomes are required.