Comparing short-term outcomes of robot-assisted and conventional laparoscopic total mesorectal excision surgery for rectal cancer in elderly patients

Table 1 Baseline data between the two groups of patients

	R-TME (n = 45)	L-TME (n = 50)	t/Z/χ2 value	P value
Age [yr, Md (IQR)]	68 (64, 71)	69 (65, 75)	-1.7631	0.078
Gender, n (%)			0.682	0.409
Male	26 (57.7)	33 (66.0)
Female	19 (42.3)	17 (34.0)
BMI (kg/m2, mean ± SD)	23.43 ± 2.52	23.85 ± 3.02	-0.733	0.467
Tumor level from anal verge (cm), n (%)			0.8182	0.664
5-10	25 (55.6)	24 (48.0)
11-15	14 (31.1)	20 (40.0)
> 15	6 (13.3)	6 (12.0)
History of cardiopulmonary disease, n (%)			0.0682	0.794
Yes	21 (46.7)	22 (44.0)
No	24 (53.3)	28 (56.0)
HGB (g/L, mean ± SD)	125.22 ± 12.31	127.22 ± 17.86	-0.6283	0.532
ALB (g/L, mean ± SD)	39.82 ± 2.77	39.19 ± 3.18	1.023	0.31
History of abdominal surgery, n (%)			3.2142	0.073
Yes	9 (20.0)	17 (34.0)
No	36 (80.0)	33 (66.0)
History of neoadjuvant therapy, n (%)			0.2532	0.615
Yes	7 (15.6)	6 (12.0)
No	38 (84.4)	44 (88.0)
ASA level, n (%)			1.1332	0.287
II	30 (66.7)	28 (56.0)
III	15 (33.3)	22 (44.0)

¹Z value.

²χ² value.

³t value.

R-TME: Robot-assisted total mesorectal excision; L-TME: Laparoscopic-assisted total mesorectal excision; BMI: Body mass index; HGB: Hemoglobin; ALB: Albumin; ASA: American Society of Anesthesiologists.

Table 2 Perioperative and pathological data between the two groups of patients

	R-TME (n = 45)	L-TME (n = 50)	t/Z/χ2 value	P value
Operation time [min, Md (IQR)]	145 (125, 187.5)	180 (148.75, 206.25)	-2.8051	0.005
Intraoperative bleeding [mL, Md (IQR)]	80 (40, 100)	100 (30, 162.5)	-0.981	0.327
Conversion to laparotomy, n (%)	0	0	-	-
Transfusion, n (%)	0 (0)	1 (2)	-	1.0
Ostomy, n (%)	16 (35.56)	26 (52.0)	2.8062	0.246
No	29	24
Ileostomy	12	21
Colostomy	4	5
Positive rate of cutting edge, n (%)	0	0	-	-
Number of lymph node dissection [n, Md (IQR)]	16 (12, 20)	15 (12, 17)	1.0931	0.278
Postoperative hospitalization days [d, Md (IQR)]	8 (7, 9)	7 (7, 10)	-0.5661	0.571
Time of first liquid feeding [d, Md (IQR)]	3 (3, 4)	4 (3, 5)	-1.9771	0.048
Drainage tube removal time [d, Md (IQR)]	6 (6, 7)	6 (5, 7)	-0.171	0.865
Foley catheter removal time [d, Md (IQR)]	3 (3, 4.5)	4 (3, 5)	-1.6671	0.096
Expenditure [RMB, Md (IQR)]	77528.84 (67871.24, 92400.57)	61756.95 (54587.1, 71251.51)	-5.2311	< 0.005

¹Z value.

²χ² value.

R-TME: Robot-assisted total mesorectal excision; L-TME: Laparoscopic-assisted total mesorectal excision.

Table 3 Postoperative complications, n (%)

Intraoperative complication	R-TME (n = 45)	L-TME (n = 50)	P value
Ureteral injury	0	0	-
Acute cardiovascular disease	0	0	-
Postoperative complication	4 (8.89)	6 (12.0)	0.874
Postoperative complication	0	0	-
Significant blood loss	0	0	-
Ileus	2 (4.44)	4 (8.0)	0.773
Abdominal infection	1 (2.22)	2 (4.0)	1
Pneumonia	0	1 (2.0)	1
Acute cerebral infarction	0	0	-
Urinary retention	1 (2.22)	1 (2.0)	1
Acute cardiovascular disease	0	0	-
Acute respiratory failure	0	0	-
Ureteral fistula	0	0	-
Chylous fistula	0	0	-
Complication Clavien-Dindo			0.644
II	4 (4.44)	5 (10.0)	0.854
III	0	1 (2.0)	0.343
IV	0	0	-
V	0	0	-

R-TME: Robot-assisted total mesorectal excision; L-TME: Laparoscopic-assisted total mesorectal excision.

Table 4 Univariate and multifactorial analysis of postoperative complications

Factors	Single factor analysis			Multiple factor analysis
	OR	95%CI	P Value	OR	95%CI	P Value
Age	1.054	0.961-1.157	0.263
Gender	0.375	0.075-1.874	0.232
Tumor level from anal verge	0.26	0.06-1.121	0.071
History of cardiopulmonary disease	2.074	0.502-8.563	0.313
BMI	1.123	0.893-1.413	0.321
History of abdominal surgery	0.674	0.133-3.411	0.633
HGB	1.028	0.985-1.074	0.2
ALB	0.974	0.78-1.217	0.818
History of neoadjuvant therapy	0	0	0.999
Operation time	1.016	1.004-1.028	0.009	1.007	0.989-1.025	0.461
Surgical path	0.715	0.188-2.718	0.623
Intraoperative bleeding	1.009	1.002-1.015	0.006	1.008	0.999-1.018	0.075
Ostomy	2.279	0.915-5.68	0.077

BMI: Body mass index; HGB: Hemoglobin; ALB: Albumin.