Update on Minimally Invasive Surgical Approaches for Rectal Cancer

Curr Oncol Rep. 2021 Aug 3;23(10):117. doi: 10.1007/s11912-021-01110-1.

Abstract

Purpose of review: This review aims to clarify the current role of minimally invasive surgery in the treatment of rectal cancer, highlighting short- and long-term outcomes from the latest trials and studies.

Recent findings: Data from previous trials has been conflicting, with some failing to demonstrate non-inferiority of laparoscopic surgical resection of rectal cancer compared to an open approach and others demonstrating similar clinical outcomes. Robot-assisted surgery was thought to be a promising solution to the challenges faced by laparoscopic surgery, and even though the only randomized controlled trial to date comparing these two techniques did not show superiority of robot-assisted surgery over laparoscopy, more recent retrospective data suggests a statistically significant higher negative circumferential resection margin rate, decreased frequency of conversion to open, and less sexual and urinary complications. Minimally invasive surgery techniques for resection of rectal cancer, particularly robot-assisted, offer clear short-term peri-operative benefits over an open approach; however, current data has yet to display non-inferiority in terms of oncological outcomes.

Keywords: Laparoscopy; Minimally invasive surgery; Rectal cancer; Robot; Total mesorectal excision; robot-assisted.

Publication types

  • Review

MeSH terms

  • Humans
  • Laparoscopy
  • Margins of Excision
  • Minimally Invasive Surgical Procedures* / adverse effects
  • Minimally Invasive Surgical Procedures* / economics
  • Minimally Invasive Surgical Procedures* / education
  • Minimally Invasive Surgical Procedures* / standards
  • Postoperative Complications / physiopathology
  • Proctectomy / adverse effects
  • Proctectomy / economics
  • Proctectomy / education
  • Proctectomy / standards
  • Quality of Life
  • Rectal Neoplasms / surgery*
  • Robotic Surgical Procedures
  • Treatment Outcome