Recently, the Annals of Gastroenterological Surgery published a research article titled “Short‐ and Long‐Term Outcomes of Open, Laparoscopic, and Robot‐Assisted Surgery for Rectal Cancer.” This study was jointly conducted by Tokyo Medical and Dental University Hospital, the University of Tokyo, and research team of Intuitive Surgical.

Using Japan’s nationwide real-world database (MDV), the study analyzed data from 28,711 patients with stage I–III rectal cancer who underwent Low Anterior Resection (LAR) between April 2018 and June 2024. It compared the short- and long-term outcomes of Open Resection (ORR), Laparoscopic Resection (LRR), and Robot-Assisted Resection (RARR). Overlap Weighting was applied to control for confounding factors and enhance the reliability of the results.

The findings showed that in terms of long-term outcomes, the 5-year Overall Survival rate was 95% for the RARR group, compared to 89% for the LRR group and 81% for the ORR group. The 5-year Recurrence-Free Survival rate was also highest in the RARR group at 93%, followed by 86% for LRR and 77% for ORR. For short-term outcomes, RARR had the lowest rate of postoperative complications at 16.1%, the shortest average hospital stay (16 days), and the lowest 30-day and 90-day mortality rates (0.10% and 0.22%, respectively).

This study represents another major population-based, real-world investigation of robotic-assisted oncologic surgery in Asia, following earlier studies conducted in Taiwan Province of China and South Korea. The study from Taiwan Province of China, involving 605 rectal cancer patients, reported a 5-year Overall Survival rate of 91.1% for the RAS group versus 86.3% for the LAP group. In the South Korean study of 5,065 patients with endometrial cancer who underwent hysterectomy, the 5-year Overall Survival rate for the robotic group reached 94.8%.

These findings provide strong clinical evidence to support the case for higher-tier reimbursement of robotic-assisted surgery and contribute valuable data to guide surgical practice and healthcare decision-making across the Asia-Pacific region.

Full Text: https://onlinelibrary.wiley.com/doi/full/10.1002/ags3.70024