Convincing evidence in favour of robotics in total mesorectal excision surgery?
Mené en Chine entre 2016 et 2020 sur 1 240 patients atteints d'un adénocarcinome du bas ou moyen rectum (âge : 18-80 ans), cet essai randomisé multicentrique compare l'efficacité, du point de vue du taux de récidive locale à 3 ans, de la chirurgie robotique et de la chirurgie laparoscopique conventionnelle
In The Lancet Gastroenterology & Hepatology, Qingyang Feng and colleagues report secondary short-term outcomes of a randomised controlled trial comparing laparoscopic with robotic total mesorectal excision (TME) for rectal cancer, including 1240 patients from 11 Chinese hospitals over 4·5 years. The trial is well designed and executed with rigor, as reflected by the high level of data completeness. This superiority trial was powered for a 50% reduction of 3-year local recurrence rate. The authors report superiority of the robotic approach with respect to specimen quality, postoperative complications, and functional outcomes. This is the first trial of such size to show a statistically significant advantage of the robotic approach.
The Lancet Gastroenterology & Hepatology , commentaire, 2021