In the past three decades, several advancements including improvement in surgical techniques and the development of new therapeutic modalities have improved treatment outcomes of rectal cancers. Anatomic resection ensures complete removal of all locoregional lymph nodes, while maintaining negative circumferential resection margin (CRM), minimizing blood loss, and preserving the autonomic pelvic nerves. Laparoscopy has become the preferred approach to resection of colon cancer. However, Adoption of the laparoscopic approach to total mesorectal excision (TME) for rectal cancer has been slower because of the difficulty of working in the deep and narrow pelvic space using long, rigid, nonarticulated instruments. Since the first robotic colon surgery in 2002, robotic systems have been expected to overcome the disadvantages of conventional laparoscopic colorectal surgery and improve the clinical outcomes of minimally invasive surgeries for colorectal cancer (CRC). In addition, preoperative concurrent chemoradiotherapy (CCRT) considerably helps in improving the local recurrence rate in patients with locally advanced rectal cancer (LARC). Therefore, preoperative CCRT is the standard treatment for patients with LARC, such as rectal cancer with T3N0 or Tany N1-2 or T4 and/or locally unresectable tumor.
Roboic-assisted rectal surgery in combined with appropriate preoperative CCRT and time interval between radiotherapy completion and roboic-assisted rectal surgery helps in achieving a favorable pathological complete- response (pCR), R0 resection rate, CRM, and sphincter preservation rate. Precision surgery in rectal cancer is safe and feasible by combining this approach with appropriate preoperative CCRT. Moreover, prrcision surgery in colon cancer may be another option. |
