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<p>Colorectal cancer (CRC) is the third most common cancer. Rectal cancer accounts for over 30% of CRC cases, presenting surgical challenges owing to its anatomical location. Robotic surgery, has been developed to address these challenges. The da Vinci® Surgical System is widely used in robotic-assisted rectal cancer surgery. This study aims to compare the short and long-term outcomes of rectal cancer surgeries performed using the da Vinci S and Xi systems. A retrospective cohort study was conducted on 284 rectal cancer patients operated with da Vinci robotic systems at tertiary hospital. The da Vinci S (IS2000) was used from January 2008 to April 2018, and the da Vinci Xi (IS4000) from April 2018 to November 2021. Clinical and pathological variables were recorded. Long-term variables were analysed in both groups. Demographic data showed no significant differences in age, sex, or preoperative ASA scores between the groups. Significant differences were found in preoperative anemia and comorbidity index, higher in the Xi system group. Intraoperative analysis indicated shorter setup and operative times with the Xi system, although it had higher rates of intraoperative complications and diverting ileostomy formation. Postoperative complication rate was higher in the Xi group although length of stay was shorter in this group. The median follow-up was 93.6 months. At 5 years, local recurrence rate was 8.2% in the da Vinci S group and 6.6% in the da Vinci Xi group (HR 0.80, 95% CI [0.30–2.18], <i>P</i> = 0.7), while disease-free survival was 78.4% and 78.9%, respectively (HR 1.04, 95% CI [0.58–1.84], <i>P</i> = 0.9), and overall survival was 64.9% in the da Vinci S group and 86.8% in the da Vinci Xi group (HR 0.54, 95% CI [0.27–1.07], <i>P</i> = 0.07). Patients treated with the da Vinci S and da Vinci Xi systems showed similar postoperative outcomes, but the da Vinci Xi system demonstrates superior overall survival. This suggests that the advanced platform may improve surgical precision and patient recovery, potentially enhancing long-term survival.</p>

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Evaluating short- and long-term clinical outcomes of robotic rectal cancer surgery: a comparison of da Vinci S and Xi systems

  • 期刊论文

  • 发表日期：

    2025年10月27日

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  • A. López-Huerta,
  • M. L. Reyes-Díaz,
  • M. A. Bonilla-Cozar,
  • F. A. Domínguez-González,
  • I. Ramallo-Solís,
  • G. Anguiano-Díaz,
  • J. Pintor-Tortolero,
  • A. M. Garcia-Cabrera,
  • J. M. Vazquez-Monchul,
  • F. De la Portilla,
  • J. Padillo,
  • R. M. Jimenez-Rodriguez

摘要

Colorectal cancer (CRC) is the third most common cancer. Rectal cancer accounts for over 30% of CRC cases, presenting surgical challenges owing to its anatomical location. Robotic surgery, has been developed to address these challenges. The da Vinci® Surgical System is widely used in robotic-assisted rectal cancer surgery. This study aims to compare the short and long-term outcomes of rectal cancer surgeries performed using the da Vinci S and Xi systems. A retrospective cohort study was conducted on 284 rectal cancer patients operated with da Vinci robotic systems at tertiary hospital. The da Vinci S (IS2000) was used from January 2008 to April 2018, and the da Vinci Xi (IS4000) from April 2018 to November 2021. Clinical and pathological variables were recorded. Long-term variables were analysed in both groups. Demographic data showed no significant differences in age, sex, or preoperative ASA scores between the groups. Significant differences were found in preoperative anemia and comorbidity index, higher in the Xi system group. Intraoperative analysis indicated shorter setup and operative times with the Xi system, although it had higher rates of intraoperative complications and diverting ileostomy formation. Postoperative complication rate was higher in the Xi group although length of stay was shorter in this group. The median follow-up was 93.6 months. At 5 years, local recurrence rate was 8.2% in the da Vinci S group and 6.6% in the da Vinci Xi group (HR 0.80, 95% CI [0.30–2.18], P = 0.7), while disease-free survival was 78.4% and 78.9%, respectively (HR 1.04, 95% CI [0.58–1.84], P = 0.9), and overall survival was 64.9% in the da Vinci S group and 86.8% in the da Vinci Xi group (HR 0.54, 95% CI [0.27–1.07], P = 0.07). Patients treated with the da Vinci S and da Vinci Xi systems showed similar postoperative outcomes, but the da Vinci Xi system demonstrates superior overall survival. This suggests that the advanced platform may improve surgical precision and patient recovery, potentially enhancing long-term survival.