ArticleUpdates in surgery2021
Robotic-assisted resection for beyond TME rectal cancer: a novel classification and analysis from a specialized center.
Article in Updates in surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed, 24 citations in OpenAlex.
- Robotic Beyond Total Mesorectal Excision With Synchronous Perineal Flap Reconstruction: Feasibility and Early Outcomes.The international journal of medical robotics + computer assisted surgery : MRCAS · 2026Article
- Critical dialogue: how imaging evaluates and guides pelvic exenteration surgery-a multidisciplinary perspective.Insights into imaging · 2026Article
- Robotic-assisted surgery for locally advanced rectal cancer beyond total mesorectal excision planes: the Mayo Clinic experience.Surgical endoscopy · 2025Article
- Outcomes of neoadjuvant chemoradiotherapy in T4 rectal cancer patients: a real-world single institution experience.Radiation oncology journal · 2024Article
- Comparing total mesorectal excision with partial mesorectal excision for proximal rectal cancer: evaluating postoperative and long-term oncological outcomes.Updates in surgery · 2024Article
- Robotic beyond total mesorectal excision for locally advanced rectal cancers: Perioperative and oncological outcomes from a multicentre case series.European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2024Article
- Perioperative and oncological outcomes following robotic en bloc multivisceral resection for colorectal cancer.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2024Article
- The role of superior hemorrhoidal vein ectasia in the preoperative staging of rectal cancer.Frontiers in oncology · 2024Article
- Robotic vs. laparoscopic intersphincteric resection for low rectal cancer: a case matched study reporting a median of 7-year long-term oncological and functional outcomes.Updates in surgery · 2022Article
- Da Vinci SP robotic approach to colorectal surgery: two specific indications and short-term results.Techniques in coloproctology · 2022Article
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Authors and funding
5 authors at 1 institution in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Locally advanced rectal cancer often requires an extended resection beyond the total mesorectal excision plane (bTME) to obtain clear resection margins. We classified three types of bTME rectal cancer following local disease diffusion: radial (adjacent pelvic organs), lateral (pelvic lateral lymph nodes) and longitudinal (below 3.5 cm from the anal verge, submitted to intersphincteric resection). The primary aim of this study was to evaluate the application of robotic surgery to the three types of bTME regarding the short and long-term oncological outcomes. Secondary aim was to identify survival prognostic factors for bTME rectal cancers. A total of 137 patients who underwent robotic-assisted bTME procedures between 2008 and 2018 were extracted from a prospectively collected database. Patient-related, operative and pathological factors were assessed. Morbidity was moderately high with 66% of patients reporting postoperative complications. Median follow up was 47 months (IQR, 31.5-66.5). Local recurrence rate was 15.3% with a statistical difference between the three types of bTME (p = 0.041). Disease progression/distant metastasis rate was 33.6%. Overall survival was significantly different (p = 0.023) with 1- and 3-years rates of: 77.8% and 55.0% (radial; n = 19); 96.6% and 84.8% (lateral; n = 30); 97.7% and 86.9% (longitudinal; n = 88). No statistical difference was observed for disease-free survival (p = 0.897). Local recurrence-free survival was significantly different between the groups (p = 0.031). Multivariate analysis showed that (y)pT (p = 0.028; HR (95% CI) 5.133 (1.192-22.097)), (y)pN (p = 0.014; HR (95% CI) 2.835 (1.240-6.482)) and type of bTME were associated to OS whilst (y)pT (p = 0.072) and type of bTME were not associated to LRFS.
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