Evidence map›Paper›PMID 41099918›Full record

Trial reportUpdates in surgery2026

Target trial on the outcomes of laparoscopic compared to robotic-assisted proctectomy in stage II-III rectal cancer.

Sameh Hany Emile, Nir Horesh, Marcus Oosenbrug, Ebram Salama, Anjelli Wignakumar, Victor Strassmann, Steven D Wexner

Abstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Updates in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. 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 · 2026
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Sameh Hany EmileColorectal Surgery Department, Cleveland Clinic Florida, Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, 2950 Cleveland Clinic Blvd., Weston, FL, 33179, USA.
Nir HoreshColorectal Surgery Department, Cleveland Clinic Florida, Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, 2950 Cleveland Clinic Blvd., Weston, FL, 33179, USA.
Marcus OosenbrugColorectal Surgery Department, Cleveland Clinic Florida, Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, 2950 Cleveland Clinic Blvd., Weston, FL, 33179, USA.
Ebram SalamaColorectal Surgery Department, Cleveland Clinic Florida, Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, 2950 Cleveland Clinic Blvd., Weston, FL, 33179, USA.
Anjelli WignakumarColorectal Surgery Department, Cleveland Clinic Florida, Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, 2950 Cleveland Clinic Blvd., Weston, FL, 33179, USA.
Victor StrassmannColorectal Surgery Department, Cleveland Clinic Florida, Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, 2950 Cleveland Clinic Blvd., Weston, FL, 33179, USA.
Steven D WexnerColorectal Surgery Department, Cleveland Clinic Florida, Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, 2950 Cleveland Clinic Blvd., Weston, FL, 33179, USA. wexners@ccf.org.ORCID http://orcid.org/0000-0001-8046-5753

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Although outcomes of laparoscopic and robotic-assisted proctectomy have been compared, the superiority of one approach over another was not proven. We used the target trial methodology to emulate a randomized clinical trial comparing laparoscopic and robotic-assisted proctectomy for rectal cancer. Data from the NCDB (2015-2021) on patients with stage II-III rectal adenocarcinoma were collected. Patients were divided into two groups: laparoscopic proctectomy (LP) and robotic-assisted proctectomy (RP). The groups were matched for baseline patient and treatment confounders to obtain balanced groups, emulating the design of a randomized trial. The primary outcome was the pathologic outcomes of each surgical approach, including the status of circumferential resection margins (CRM), surgical margins, and number of examined lymph nodes. Secondary outcomes included conversion to open surgery, hospital stay, and 30- and 90-day mortality. After matching, 5631 patients were included in each group. The RP and LP groups had similar rates of positive CRM (10.5% vs. 9.4%, p = 0.072), positive surgical margins (6% vs. 6.3%, p = 0.528), examined lymph nodes number (median: 15 vs. 15, p = 0.105), 30-day mortality (0.7% vs. 0.9%, p = 0.405), 90-day mortality (1.5% vs. 1.8%, p = 0.333), and unplanned 30-day readmission (6.6% vs. 6.2%, p = 0.477). RP was associated with shorter hospital stay (median: 4 vs. 5 days, p < 0.001) and lower rate of conversion to open surgery (5.8% vs. 13.6%, OR: 0.39, 95%CI 0.34-0.45, p < 0.001). This target trial found RP and LP for rectal cancer associated with similar clinical and pathologic outcomes. RP was associated with fewer conversions and shorter hospital stays than LP.

Indexed as

AdenocarcinomaLaparoscopyProctectomyRectal NeoplasmsRobotic Surgical ProceduresAgedFemaleHumansLength of StayMaleMargins of ExcisionMiddle AgedNeoplasm StagingTreatment OutcomeLaparoscopicOutcomesProctectomyRectal cancerRobotic-assistedTarget trial

Identifiers

PMID41099918
PMCPMC12909341

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.