ORIGINAL RESEARCH article
Front. Surg.
Sec. Colorectal and Proctological Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1628649
This article is part of the Research TopicEvaluating surgical techniques and perioperative strategies in colorectal cancer treatmentView all articles
Comparing robot-assisted vs. laparoscopic proctectomy for rectal cancer surgical and oncological outcomes
Provisionally accepted
- 1Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- 2Shenzhen People's Hospital, Shenzhen, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Robotic-assisted surgery (RAP) is increasingly used for rectal cancer, but its long-term benefits over laparoscopy (LP) remain debated. While RAP offers technical advantages, its clinical equivalence requires further validation, particularly in anatomically challenging cases.We conducted a retrospective analysis of all eligible patients who underwent RAP or LP for rectal cancer at Tianjin Medical University Cancer Institute and Hospital between 2019 and 2024.Results: In the overall cohort, RAP demonstrated significantly longer operative times (246.69 vs. 174.52 min, p < 0.001), greater blood loss (109.77 vs. 57.58 mL, p < 0.001), and higher costs (117,030.88 vs. 81,054.16 yuan, p < 0.001) compared to LP, with only a marginally shorter postoperative stay (8.47 vs. 8.64 days, p < 0.05). In terms of postoperative complications, RAP showed a trend towards fewer overall Clavien-Dindo Grade ≥ III complications (1.2% vs. 6.6%) compared to LP, although this difference was not statistically significant (p = 0.064). There were no significant differences in disease-free survival (DFS) (p = 0.575) or overall survival (OS) (p = 0.619) between the two groups. For the subgroup analysis of rectal cancers ≤ 5 cm from the anus, RAP achieved superior surgical precision, with 100% negative circumferential resection margin (CRM) (vs. 87.1% in LP, p = 0.042) and 100% complete mesorectal integrity (vs. 83.9% in LP, p = 0.053), alongside faster functional recovery (time to first flatus: 3.47 vs. 3.90 days, p = 0.034; time to urination: 2.10 vs. 2.65 days, p = 0.007). Recurrence rates were lower with RAP (10% vs. 19.4%), though survival outcomes remained similar between RAP and LP (p = 0.253) Conclusion: While RAP incurs longer operative times and higher costs, it demonstrates superior precision in anatomically complex cases, evidenced by improved CRM status and mesorectal preservation. Although survival outcomes remain comparable, RAP's advantages in functional recovery and potential recurrence reduction warrant further investigation.
Keywords: Laparoscopy, Proctectomy, Rectal Neoplasms, Robotic Surgical Procedures, survival analysis
Received: 14 May 2025; Accepted: 18 Jul 2025.
Copyright: © 2025 Wang, Liu, WANG, Huang and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jinghao Huang, Shenzhen People's Hospital, Shenzhen, China
Junfeng Wang, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.