Robotic surgery versus laparoscopic surgery for rectal cancer: a comparative study on surgical safety and functional outcomes

Backgrounds: This study aims to evaluate the clinical efficacy and functional outcomes of DA Vinci (Xi)-assisted surgery compared to conventional laparoscopic surgery for middle and low rectal cancer, focusing on oncologic cure and functional preservation. Methods: Between December 2020 and June 2021, 102 patients with middle and low rectal cancer (tumour lower margin <= 10 cm) were enrolled at the affiliated Hospital of Xuzhou Medical University. Participants were divided into two groups: robot-assisted (n = 51) and laparoscopy-assisted (n = 51). Each group underwent a radical resection using their assigned method. Clinical and functional outcomes were analysed post-surgery. Results: Preoperative data did not differ significantly between groups (P > 0.05). All surgeries were successfully completed without conversion to open surgery. The robotic group experienced significantly less intraoperative blood loss (55.2 +/- 29.8 mL vs. 109.5 +/- 58.5 mL) and faster recovery in gastrointestinal function (35.1 +/- 9.4 h vs. 40.7 +/- 1.9 h), diet recovery (2.1 +/- 0.8 days vs. 2.9 +/- 0.4 days), and catheter removal (2.9 +/- 2.7 days vs. 5.3 +/- 2.1 days). The robotic group also dissected more lymph nodes (23 +/- 6 vs. 15 +/- 4). However, they had longer operative times (239.8 +/- 29.6 min vs. 141.1 +/- 18.5 min) and higher hospital costs. Satisfaction levels regarding defecation, voiding, and sexual functions were notably higher in the robotic group. Conclusion: No significant differences in surgical safety or immediate postoperative outcomes were observed between robotic and laparoscopic approaches. However, robotic surgery demonstrated superior lymph node dissection, anal function preservation, and gastrointestinal recovery, enhancing overall functional outcomes.