Gender-Specific Cancer-Related Survival Analysis of Robotic Versus Laparoscopic Low Anterior Resection for Rectal Adenocarcinoma: A Multicenter Study

Abstract

Aim: This study compared short- and long-term outcomes of robotic and laparoscopic low anterior resection (LAR) for rectal adenocarcinoma using sex-stratified analyses. Methods: Patients who underwent elective robotic or laparoscopic LAR for rectal cancer were included. Prospectively maintained database of outcomes was analysed retrospectively. To minimise selection bias, groups were matched. Results: Of 409 identified patients, 380 met the eligibility criteria (mean age: 61 years, BMI: 26.2 kg/m(2)). In a matched cohort of males (n = 172) and females (n = 114), robotic surgery was associated with significantly shorter hospital stay (p < 0.01). Harvested lymph nodes, margins, morbidity and local recurrence were comparable in males (p > 0.05). Robotic surgery in females was associated with fewer harvested lymph nodes (p = 0.01). Five-year disease-specific survival rates did not significantly differ between approaches in either gender. Conclusions: Robotics and laparoscopic LAR achieved similar oncologic outcomes. The findings should be interpreted as sex-stratified comparisons rather than evidence of differential effect of surgical approach according to sex.