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Chen et al. Mini-invasive Surg 2018;2:43 I http://dx.doi.org/10.20517/2574-1225.2018.42 Page 5 of 12

Table 1. Baseline characteristics and perioperative outcomes of 60 patients with low-lying
rectal cancer who underwent robotic-assisted total mesorectal excision
Characteristics Value/number
Age (years, median) (range) 62 (32-87)
Gender
Female 24 (40%)
Male 36 (60%)
Distance from anal verge (cm, median) (range) 3.5 (1-5)
Pre-operation CCRT
Yes 49 (81.7%)
No 11 (18.3%)
Pre-operation chemotherapy regimen 49
FOLFOX 36 (73.5%)
Fluoropyrimidine-based 13 (26.5%)
Time interval between radiotherapy completion and robotic surgery (day, 91 (47-363)
median) (range) (49 patients undergoing pre-operation chemotherapy)

ASAclassification
II 36 (60%)
III 24 (40%)
BMI kg/m (median) (range) 23.07 (17.50-30.9)
2
Procedure
LAR 19 (31.7%)
ISR 37 (61.7%)
APR 4 (6.6%)
Protective diverting colostomy
Yes 45 (75%)
No 15 (25%)
Docking time (min, median) (range) 5 (3-10)
Console time (min, median) (range) 215 (150-527)
Operation time (min, median) (range) 320 (240-710)
Estimated blood loss (mL, median) 95 (15-450)
Time of first flatus passage (day) (median, range) 2 (1-10)
Time of resuming soft diet (day) (median, range) 4 (2-13)
Postoperative hospital stay (day) (median, range) 6 (5-30)
Postoperative first day VAS pain score (median, range) 3 (1-7)

CCRT: concurrent chemoradiotherapy; ASA: American Society of Anesthesiologists; BMI: body mass index; LAR: low anterior resection;
ISR: intersphincteric resection; APR: abdominoperineal resection; VAS: visual analog scale

verting loop transverse colostomy was performed in 45 patients, including 37 patients and 8 patients who
underwent ISR and LAR, respectively. The median operating time was 320 min (range, 240-710), with a
median blood loss of 95 mL (range, 15-450). Median length of stay was 6 days (range 5-30). No mortality
was observed within 30 days following the procedure. Furthermore, no intraoperative complications or
conversion to open surgery were noted.

Postoperative complications
Table 2 presents postoperative complications. Three patients required reoperation within 30 days following
the procedure, two for anastomotic leak, and one for postoperative bleeding. Transverse loop colostomy
was performed for anastomotic leak, and we monitored postoperative bleeding through laparotomy. Other
complications included prolonged ileus (n = 3), urethral injury (n = 1), and coloanal anastomosis stenosis (n
= 2). We used colonfiberoscope dilation for the two patients with coloanal anastomosis stenosis. The others
morbidities recovered uneventfully after conservative treatment.

Pathological and oncological outcomes
The pathological characteristics and oncological outcomes of all 60 patients are listed in Table 3. Preopera-
tive clinical staging demonstrated that the majority of the patients had locally advanced rectal cancer: T3,