{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T05:47:27Z","timestamp":1791697647894,"version":"4.3.4"},"reference-count":48,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2017,12,1]],"date-time":"2017-12-01T00:00:00Z","timestamp":1512086400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Laparoscopic rectal surgery is associated with a steep learning curve and high conversion rate despite progress in equipment design and consistent practice. The robotic system has shown an advantage over the laparoscopic approach due to stable three\u2010dimensional views, improved dexterity and better ergonomics. These factors make the robotic approach more favourable for rectal surgery. The aim of this study was to compare the perioperative outcomes of laparoscopic and robotic rectal cancer surgery in high\u2010risk patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A prospectively collected dataset for high\u2010risk patients who underwent rectal cancer surgery between May 2013 and November 2015 was analysed. Patients with any of the following characteristics were defined as high risk: a body mass index \u226530, male gender, preoperative chemoradiotherapy, tumour &lt;8\u00a0cm from the anal verge and previous abdominal surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 184 high\u2010risk patients were identified: 99 in the robotic group and 85 in the laparoscopic group. Robotic surgery was associated with a significantly higher sphincter preservation rate (86% <jats:italic>vs<\/jats:italic> 74%, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.045), shorter operative time (240 <jats:italic>vs<\/jats:italic> 270\u00a0min, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.013) and hospital stay (7 <jats:italic>vs<\/jats:italic> 9\u00a0days, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.001), less blood loss (10 <jats:italic>vs<\/jats:italic> 100\u00a0ml, <jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.001) and a smaller conversion rate to open surgery (0% <jats:italic>vs<\/jats:italic> 5%, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.043) compared with the laparoscopic technique. Reoperation, anastomotic leak rate, 30\u2010day mortality and oncological outcomes were comparable between the two techniques.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Robotic surgery in high\u2010risk patients is associated with higher sphincter preservation, reduced blood loss, smaller conversion rates, and shorter operating time and hospital stay. However, further studies are required to evaluate this notion.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.13783","type":"journal-article","created":{"date-parts":[[2017,6,23]],"date-time":"2017-06-23T12:30:37Z","timestamp":1498221037000},"page":"1092-1099","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":76,"title":["Robotic <i>vs<\/i> laparoscopic rectal surgery in high\u2010risk patients"],"prefix":"10.1111","volume":"19","author":[{"given":"J.","family":"Ahmed","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery Poole Hospital NHS Foundation Trust Poole UK"},{"name":"Department of Colorectal Surgery Minimally Invasive Colorectal Unit Queen Alexandra Hospital NHS Trust Portsmouth UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Poole Hospital NHS Foundation Trust Poole 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