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Surgical outcomes of robot-assisted super-low anterior resection or robot-assisted rectal resection with transanal anastomosis: a retrospective cohort study
(ROSEMARY study)

Surgical outcomes of robot-assisted super-low anterior resection or robot-assisted rectectomy with transanal anastomosis: a retrospective cohort study
(ROSEMARY study)

1250

Patients with rectal cancer who underwent robot-assisted super-low anterior resection (R-sLAR) or robot-assisted rectal resection with transanal anastomosis (R-ISR or R-TaTME) between January 1, 2020 and December 31, 2021 (a 2-year period).

Progress almost as planned

Postoperative complications of Clavien-Dindo grade III or higher within 30 days were observed in 109 patients (9.0%), with anastomotic leakage being the most common (3.4%), followed by ileus (1.3%).

A total of 1,250 cases were registered, of which 40 were excluded, leaving 1,210 patients for analysis (886 undergoing robot-assisted super-low anterior resection and 324 undergoing robot-assisted intersphincteric resection). The median operative time was 364 minutes (IQR, 277-479 minutes), and the median blood loss was 17 mL (IQR, 0-50 mL). Conversion to open surgery occurred in only one case in the robot-assisted super-low anterior resection group. Clavien-Dindo grade III or higher complications within 30 postoperative days were observed in 109 patients (9.0%), with anastomotic leakage being the most common (3.4%), followed by ileus (1.3%). Only one patient died within 30 days after surgery. The 3-year overall survival rates were 98.4% for pStage 0/I, 96.2% for pStage II, 89.5% for pStage III, and 68.0% for pStage IV.

A total of 1,250 cases were registered, of which 40 were excluded, leaving 1,210 patients for analysis (886 undergoing robot-assisted super-low anterior resection and 324 undergoing robot-assisted intersphincteric resection). The median operative time was 364 minutes (IQR, 277-479 minutes), and the median blood loss was 17 mL (IQR, 0-50 mL). Conversion to open surgery occurred in only one case in the robot-assisted super-low anterior resection group. Clavien-Dindo grade III or higher complications within 30

Feb. 27, 2026

June. 06, 2025

https://www.surgjournal.com/article/S0039-6060(25)00266-1/abstract

No

https://jrct.mhlw.go.jp/latest-detail/jRCT1010220027

Takemasa Ichiro

Osaka Keisatsu Hospital

Karasugatsuji 2-6-40, Tennouji-ku, Osaka City, Osaka, Japan

itakemasa@oim.or.jp

Miyo Masaaki

Osaka Prefectural Hospital Organization Osaka International Cancer Institute

3-1-69,Otemae,Chuo-ku,Osaka-shi,Osaka, Japan

+81-6-6945-1181

masaaki.miyo@oici.jp

Complete

Dec. 02, 2022

Observational

1) Patients who underwent R-sLAR or robot-assisted rectal resection with transanal anastomosis (R-ISR or R-TaTME) between January 1, 2020 and December 31, 2021
2) Patients histologically diagnosed with rectal cancer (pap, tub, por, muc, sig, med, or asc)

1) Patients who indicated their intention to refuse to use the data for this study
2) Other patients who are judged to be inappropriate by the principal investigator or co-investigator

Both

rectal cancer

rectal cancer

D012004

<Short-term postoperative results>
Total surgery time and console time
Intraoperative bleeding
Proportion of transition to laparotomy
Occurrence rate of intraoperative adverse events
Postoperative hospital stay
Severity of residual cancer
Rate of all complications within 30 days after surgery
Rehospitalization rate within 30 days after surgery
Reoperation rate within 30 days after surgery
Death rate at discharge
30 day postoperative mortality rate
90 day postoperative mortality rate
<Long-term postoperative outcomes>
3-year local recurrence-free survival (LRFS)
3-year disease-free survival (DFS)
3-year overall survival (OS)

6-6771-6051

Oct. 13, 2022

none