Robotic multivisceral pelvic resection: experience from an exenteration unit
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ORIGINAL ARTICLE
Robotic multivisceral pelvic resection: experience from an exenteration unit N. Smith2,4 · D. G. Murphy1,3,5 · N. Lawrentschuk1,2,3,4 · J. McCormick1,2,3,4 · A. Heriot1,2,4,5 · S. Warrier1,2,4 · A. C. Lynch1,2,4,5 Received: 4 January 2020 / Accepted: 2 July 2020 © Springer Nature Switzerland AG 2020
Abstract Background Pelvic exenteration remains a viable and effective treatment option for the management of locally advanced or recurrent pelvic malignancy. The aim of this study was to present an early experience of robotic multivisceral resection of pelvic malignancy, and to compare this experience with similar series through a systematic review of the literature. Methods A retrospective study was performed on patients who had robotic-assisted multi-visceral resection for pelvic malignancy at a single Colorectal Surgical unit based between two tertiary academic hospitals. Primary outcomes observed included operation type, operation time, perioperative complications, and hospital length of stay. Secondary outcomes included R0 resection status, lymph node harvest, and rate of recurrence at clinical follow-up. Results Eight cases of robotic multivisceral resection were performed for primary locally advanced pelvic malignancy involving a rectal resection as part of their operative management. The median age of patients undergoing resection was 56 years (range 29–83 years). The male:female ratio was 6:2. The mean total operating time was 8.3 h (range 6–10 h). Perioperative blood transfusion requirements were minimal. Mean hospital length of stay was 15 days (range 7–26 days). No patients experienced any serious postoperative morbidity or mortality. All patients had clear margins on histological assessment and no patients have recurrence at 12-month follow-up. Conclusions Robotic multivisceral resection for malignant disease of the pelvis is a safe and feasible minimally invasive approach in highly selected cases. Keywords Pelvic exenteration · Pelvic neoplasms · Colorectal neoplasms · Robotic surgical procedures · Neoplasm recurrence, local · Follow-up studies
This manuscript was presented as a poster presentation at the American Society of Colon and Rectal Surgeons (ASCRS) Annual Meeting, June 1st–June 5th 2019 in Cleveland, OH, USA. S. Warrier and A. C. Lynch are co senior. * N. Smith [email protected] 1
Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
2
Division of Cancer Research, Peter MacCallum Cancer Centre, 305 Gratton St., Melbourne, VIC 3000, Australia
3
Division of Urology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
4
Department of Surgery, Epworth Healthcare, Richmond, VIC, Australia
5
Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia
Introduction In the 70 years since its description by Brunschwig [1] in 1948, total pelvic exenteration (TPE) has remained a viable option for the management of complex advanced or recurrent pelvic malignancy [2]. Multivisceral pelvic
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