Comparative analysis of the short and medium-term efficacy of the Da Vinci robot versus laparoscopic total mesangectomy for rectal cancer

Table 1 Comparison of general data of rectal cancer patients between the two groups

Clinicopathological indicators	L-TME group (n = 112)	R-TME group (n = 128)	Statistical	P value
ASA grading			χ2 = 0.006	0.997
Class I	59	68
Class II	39	44
Class III	14	16
Preoperative serum CEA	2.93 (6.06)	3.13 (4.78)	Z = -0.005	0.996
Tumor distance from anal margin (cm)	6 (6)	5 (6)	Z = -0.963	0.335
Distance distribution of tumor from anal margin			χ2 = 0.592	0.744
< 5 cm	29	34
5-10 cm	65	69
10-15 cm	18	25
Comorbidities
Diabetes	24	28	χ2 = 0.007	0.933
Dypertension	32	26	χ2 = 2.223	0.136
Chronic obstructive pulmonary disease	15	12	χ2 = 0.966	0.326
Emphysema	6	8	χ2 = 0.087	0.768
Varicose veins of the lower extremities	4	3	χ2 = 0.318	0.573
Deep vein thrombosis of the lower extremities	2	1	χ2 = 0.488	0.485
Sinus bradycardia	1	3	χ2 = 0.767	0.381
Atrial fibrillation	1	2	χ2 = 0.217	0.641
NRS2002 Score			χ2 = 1.493	0.222
0-2 points	99	106
≥ 3 points	13	22
TNM staging			χ2 = 0.138	0.933
Stage I	34	38
Stage II	42	46
Stage III	36	44
LARS			χ2 = 5.070	0.079
None	89	115
Mild	19	11
Severe	4	2
IIEF-5 score	112	128	χ2 = 7.443	0.059
Accessibility	90	118
Mild impairment	13	5
Moderate impairment	7	4
Severe impairment	2	1
Follow-up time (months)	43.5 (11.5)	42.0 (5.8)	Z = -1.593	0.111

L-TME: Laparoscopic total mesorectal resection; R-TME: Robotic total mesorectal resection; ASA: American Society of Anesthesiologists; CEA: Carcinoembryonic antigen; TNM: Tumor-node-metastasis; LARS: Low anterior rectal resection syndrome; IIEF-5: International Questionnaire on Erectile Function-5.

Table 2 Comparison of intraoperative and postoperative outcomes of rectal cancer patients

Clinical indicators	L-TME group (n = 112)	R-TME group (n = 128)	Statistical	P value
Conversion to laparotomy	6	1	χ2 = 4.417	0.036
Complications			χ2 = 7.290	0.007
Yes	36	22
Not	76	106
Complications Clavien-Dindo			χ2 = 6.847	0.144
Class I	95	118
Class II	3	2
Class III	14	6
Class IV	0	1
Level V	0	1
Postoperative complications
Anastomal fistula	13	5	χ2 = 5.106	0.024
Anastomotic bleeding	3	2	χ2 = 0.365	0.546
The anastomotic is narrow	4	2	χ2 = 0.989	0.32
Urinary tract infections	2	1	χ2 = 0.488	0.485
Urinary retention	3	2	χ2 = 0.365	0.546
Ileus	8	6	χ2 = 0.656	0.418
Infection of the incision in the abdominal wall	2	3	χ2 = 0.091	0.763
Pulmonary embolism	0	1	-	1
Sexual dysfunction	1	0	-	0.467
Length of postoperative hospital stay (d)	17 (3)	6 (2)	Z = -2.541	0.011

L-TME: Laparoscopic total mesorectal resection; R-TME: Robotic total mesorectal resection.

Table 3 Comparison of postoperative pathological examination results between the two groups of rectal cancer patients

Pathological indicators	L-TME group (n = 112)	R-TME group (n = 128)	Statistical	P value
Number of lymph nodes dissected	12 (7)	16 (8)	Z = -3.295	0.001
Tumor diameter (cm)	4.0 (1.5)	3.5 (2.4)	Z = -0.006	0.996
Pathological grading			χ2 = 0.607	0.738
High differentiation	5	8
Medium differentiation	95	104
Low differentiation	12	16
Positive circumcision margin (case)	8	2	χ2 = 4.658	0.031
AJCC staging			χ2 = 0.002	0.999
Phase I	28	32
Phase II	44	50
Phase III	40	46
Mesorectal resection (case)			χ2 = 5.060	0.08
completely	104	126
Near-complete	6	2
Imperfection	2	0
Nerve invasion	23	18	χ2 = 1.767	0.184
Vascular invasion	25	20	χ2 = 1.758	0.185

L-TME: Laparoscopic total mesorectal resection; R-TME: Robotic total mesorectal resection; AJCC: American Joint Committee on Cancer.

Table 4 Comparison of the 3-year survival outcomes of rectal cancer patients

	TNM staging		Phase I		Phase II		Phase III
	Number of cases	%	Number of cases	%	Number of cases	%	Number of cases	%
Disease-free survival	83	74.1	25	89.3	37	84.1	21	52.5
	109	85.2	30	93.8	44	88	35	76.1
	4.962		0.403		0.323		5.799
	0.026		0.525		0.57		0.016
Total survival	91	81.3	26	92.9	39	88.6	26	65
	117	91.4	31	96.9	47	94	39	84.8
	5.494		0.499		0.852		4.787
	0.019		0.48		0.356		0.029

TNM: Tumor-node-metastasis.