ArticleSurgical endoscopy2025
Robotic surgery enhances patients' survival in rectal cancer: a propensity score-weighted multicenter cohort study.
Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed.
- On the edge: pathology specimen quality in robotic and laparoscopic proctectomy, a propensity score-matched study.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2026Article
- Circumferential resection margin status and longterm survival outcomes following robotic-assisted versus laparoscopic surgical resection for locally-advanced rectal cancer: a National Cancer Database (NCDB) study.Surgical endoscopy · 2026Article
- Comparison of Minimally Invasive Colectomy Between Intra- Versus Extra-Corporeal Anastomosis Technique (COMMIT Study): Short-Term Analysis.Annals of gastroenterological surgery · 2026Article
- Robotic-Assisted Surgery for Colorectal Cancer Treatment in 2026: An Updated Narrative Review.Journal of clinical medicine · 2026Review
- Experience with hinotoriJournal of the anus, rectum and colon · 2026Article
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Authors and funding
23 authors.
Funding
Abstract
backgroundAlthough robotic surgery for rectal cancer has demonstrated favorable short-term outcomes, its mid-term benefits remain unclear. Moreover, randomized controlled trials have not evaluated its effectiveness in real-world settings.
methodsThis study included patients diagnosed with stage I-III middle or lower rectal adenocarcinoma who underwent minimally invasive surgery between 2018 and 2021 at 16 hospitals in Japan. The inverse probability of treatment weighting method based on propensity score was used to adjust for confounding factors. The primary outcome was the 3-year relapse-free survival (RFS).
resultsOf the 1053 patients, 536 underwent robotic surgery and 517 underwent laparoscopic surgery. The mean operative time was longer in the robotic group (robotic: 435 min vs. laparoscopic: 366 min). No significant difference was observed in Clavien-Dindo Grade II or higher any complications (robotic: 28.4% vs. laparoscopic: 32.0%, risk ratio [RR] 0.89, 95% confidence interval [CI]: 0.72-1.09). The rate of pathological complete resection was significantly higher in the robotic group (robotic: 98.2% vs. laparoscopic: 95.3%, RR 1.03, 95% CI 1.00-1.06). The 3-year RFS was significantly better in the robotic group (robotic: 83.6% vs. laparoscopic: 78.2%, hazard ratio [HR] 0.72, 95% CI: 0.53-0.99), and the 3-year overall survival also showed a favorable trend in the robotic group (robotic: 94.4% vs. laparoscopic: 90.6%; HR 0.60, 95% CI 0.35-1.03). Subgroup analysis indicated that robotic surgery for rectal cancer may be more effective in male patients or those with T4 tumors.
conclusionRobotic surgery for rectal cancer may be associated with a higher complete resection rate and improved 3-year RFS compared with conventional laparoscopic surgery in a real-world setting.
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