Analysis Of Bowel Function,urogenital Function,and Long-term Follow-up Outcomes Associated With Robotic And Laparoscopic Sphincter-preserving Surgical Approaches To Total Mesorectal Excision In Low Rectal Cancer:A Retrospective Cohort Study

Objective The aim of this study is to compare short-term clinical efficacy and long-term followup outcomes of robotic-assisted sphincter-preserving surgery（RAS）with laparoscopic-assisted sphincter-preserving surgery（LAS）for low rectal cancer.MethodThis was a single-center retrospective cohort study of consecutive patients diagnosed with low rectal cancer who underwent laparoscopic or robotic sphincter-preserving surgery（RAS 200,LAS 486）between January 1,2015 and July 1,2018.ResultsMean operation time was 249±64 min for RAS group and 203±47 min for LAS group（P<0.001）.the rate of temporary ileostomy was 64.5% for RAS and 51.6% for LAS（P=0.002）.Time to liquid diet,firstly leaving bed time,removing catheter time and length of stay showed significant difference（all P<0.001）.The distance of distal resection margin in RAS group was closer than LAS group（P=0.004）.The recovery from decreased urinary and female sexual function took more than 6 months after surgery in LAS group（P<0.0001）but 3 months in RAS group（P<0.0001）.Male sexual function 6 months postoperatively was better in RAS group than LAS group（P<0.001）.The Wexner score showed similar results at 6 months after surgery（P<0.001）.And no significantly group difference were observed for OS or DFS at 3 and 5years after surgery.ConclusionBoth robotic and laparoscopic sphincter-preserving surgery for low rectal cancer are safe and effective in clinical efficacy and long-term outcomes.The robotic approach showed some advantages in short-term recovery of urogenital and anorectal function.