PURPOSE

The potential benefits of robotic surgery (RS) for rectal cancer (RC) remain uncertain. The objective of this study was to evaluate the short- and long-term outcomes of RS compared to conventional laparoscopic surgery (LS) for stage I-III middle or lower RC.

METHODS

This study retrospectively analyzed 350 consecutive patients with stage I-III middle or lower RC who underwent curative surgery from 2017 to 2021, employing propensity score matching (PSM) analysis.

RESULTS

Of 350 patients, 128 patients underwent RS. After PSM, we enrolled 256 patients. Median follow-up was 59.8 months. Before PSM, significant differences were observed between groups regarding primary tumor site (p = 0.02). After PSM, no significant differences between groups were observed in terms of operative time, blood loss, conversion rate, intra-operative and postoperative complications, or number of lymph nodes harvested. After PSM, 3- and 5-year cumulative LR rates were 3.2% and 3.2% in the RS group, and 2.8% and 3.2% in the LS group, respectively. The cumulative distant recurrence (DR) rates in the RS group were 13.4% at 3-year and 15.1% at 5-year, whereas in the LS group, they were 14.9% and 18.7%, respectively. No notable differences in cumulative LR or DR rates were evident between groups. Furthermore, no notable differences were observed between groups regarding overall, cancer-specific, or recurrence-free survival according to stage.

CONCLUSIONS

RS appears to be viable and safe treatment approach for patients with middle or lower RC, offering short- and long-term outcomes comparable to those of LS.