Robotic-assisted vs laparoscopic-assisted radical resection for rectal cancer: A comparison of surgical indices, postoperative recovery, and complications

Table 1 Patients’ baseline data, n (%)/mean ± SD/median (interquartile range)

Indicators	Laparoscopic group (n = 100)	Robotic group (n = 100)	χ2/t/Z	P value
Gender			0.183	0.669
Male	55 (55.00)	58 (58.00)
Female	45 (45.00)	42 (42.00)
Age (years)	55.34 ± 9.47	54.06 ± 11.08	0.878	0.381
Body mass index (kg/m2)	22.00 (20.25, 24.00)	22.00 (20.00, 24.00)	-0.436	0.663
American Society of Anesthesiologists grading			1.624	0.203
I	43 (43.00)	52 (52.00)
II	57 (57.00)	48 (48.00)
Tumor distance from the anal verge (cm)	6.00 (4.00, 7.75)	6.00 (4.25, 8.00)	-0.947	0.344
Surgical technique			1.663	0.197
Low anterior resection	70 (70.00)	78 (78.00)
Abdominoperineal resection	30 (30.00)	22 (22.00)

Table 2 Surgical indexes, n (%)/mean ± SD/median (interquartile range)

Indicators	Laparoscopic group (n = 100)	Robotic group (n = 100)	χ2/t/Z	P value
Operation time (minute)	138.66 ± 21.93	139.26 ± 24.50	0.182	0.855
Incision length (cm)	6.11 ± 1.70	5.28 ± 1.50	3.661	< 0.001
Intraoperative blood loss (mL)	119.50 (85.25, 149.00)	67.00 (44.25, 92.75)	-8.212	< 0.001
Intraoperative blood transfusion	3 (3.00)	0 (0.00)	3.046	0.081
Prophylactic ostomy	20 (20.00)	23 (23.00)	0.267	0.606

Table 3 Pain status on post-operative day 1, n (%)

NRS (points)	Laparoscopic group (n = 100)	Robotic group (n = 100)	χ2	P value
1	10 (10.00)	12 (12.00)	4.364	0.359
2	26 (26.00)	28 (28.00)
3	30 (30.00)	38 (38.00)
4	29 (29.00)	20 (20.00)
5	5 (5.00)	2 (2.00)

NRS: Numeric Rating Scale.

Table 4 Postoperative pathological indicators, n (%)/median (interquartile range)

Indicators	Laparoscopic group (n = 100)	Robotic group (n = 100)	χ2/Z	P value
Mesorectal excision completeness grading			1.087	0.297
Intact	90 (90.00)	94 (94.00)
Nearly complete	10 (10.00)	6 (6.00)
Incomplete	0 (0.00)	0 (0.00)
Tumor length (cm)	4.08 (3.54, 4.78)	4.22 (3.56, 4.76)	-0.601	0.548
Tumor differentiation			1.070	0.301
High	16 (16.00)	11 (11.00)
Moderate or low	84 (84.00)	89 (89.00)
Lymph node count	13.00 (11.00, 17.00)	15.00 (11.00, 19.00)	-1.840	0.066
T-staging			4.167	0.244
T1	6 (6.00)	10 (10.00)
T2	5 (5.00)	11 (11.00)
T3	14 (14.00)	10 (10.00)
T4	75 (75.00)	69 (69.00)
N-staging			1.146	0.564
N0	63 (63.00)	60 (60.00)
N1	20 (20.00)	26 (26.00)
N2	17 (17.00)	14 (14.00)
TNM staging			0.673	0.714
I	11 (11.00)	14 (14.00)
II	50 (50.00)	45 (45.00)
III	39 (39.00)	41 (41.00)

TNM: Tumor, node, and metastasis.

Table 5 Pre- and post-operative tumor markers, mean ± SD

Indicators	Laparoscopic group (n = 100)	Robotic group (n = 100)	t	P value
CEA (μg/mL)
Preoperative	23.27 ± 4.62	22.40 ± 3.91	1.437	0.152
After surgery	14.80 ± 5.28c	15.91 ± 5.21c	1.496	0.136
CA19-9 (U/mL)
Preoperative	47.70 ± 9.31	47.16 ± 8.47	0.429	0.668
After surgery	25.28 ± 6.26c	24.86 ± 7.32c	0.436	0.663
CA242 (U/mL)
Preoperative	40.14 ± 7.08	39.94 ± 5.53	0.223	0.824
After surgery	20.72 ± 5.28c	19.40 ± 4.95c	1.824	0.070

^cP < 0.001 vs preoperative in the same group.

CEA: Carcinoembryonic antigen; CA19-9/CA242: Carbohydrate antigen 19-9/242.

Table 6 Postoperative complications, n (%)

Indicators	Laparoscopic group (n = 100)	Robotic group (n = 100)	χ2	P value
Postoperative haemorrhage	2 (2.00)	0 (0.00)
Incision infection	1 (1.00)	0 (0.00)
Rectovaginal fistula	2 (2.00)	0 (0.00)
Voiding dysfunction	3 (3.00)	2 (2.00)
Anastomotic leakage	2 (2.00)	5 (5.00)
Total	10 (10.00)	7 (7.00)	0.579	0.447

Table 7 Hospitalization expenses, mean ± SD/median (interquartile range)

Indicators	Laparoscopic group (n = 100)	Robotic group (n = 100)	t/Z	P value
Surgical expenses (in 10000 CNY)	1.79 ± 0.77	2.91 ± 1.03	8.709	< 0.001
Non-surgical expenses (in 10000 CNY)	2.48 (1.53, 3.64)	2.49 (1.76, 3.01)	-0.457	0.648
Total hospitalization expenses (in 10000 CNY)	4.35 ± 1.45	5.33 ± 1.45	4.779	< 0.001

Table 8 Pre- and post-operative quality of life

Indicators	Laparoscopic group (n = 100)	Robotic group (n = 100)	χ2/t	P value
Physiological function (points)
Preoperative	65.66 ± 6.62	65.98 ± 6.36	0.349	0.728
Postoperative	76.70 ± 6.11c	82.98 ± 7.69c	6.394	< 0.001
Mental state (points)
Preoperative	65.08 ± 5.64	63.56 ± 7.39	1.635	0.104
Postoperative	75.07 ± 7.12c	82.71 ± 8.52c	6.881	< 0.001
Physical health (points)
Preoperative	66.99 ± 6.81	68.33 ± 7.36	1.336	0.183
Post-operative	75.58 ± 7.46c	83.32 ± 8.95c	6.643	< 0.001
Social function (points)
Preoperative	69.96 ± 8.10	69.71 ± 6.99	0.234	0.816
Postoperative	72.10 ± 6.82c	82.29 ± 8.24c	6.527	< 0.001

^cP < 0.001 vs preoperative in the same group.