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Page 8 of 11                                         Abdalla et al. Mini-invasive Surg 2019;3:39  I  http://dx.doi.org/10.20517/2574-1225.2019.38

                                                  Table 4. Pathologic outcomes
                                                                           Overall (n = 20)
                            Tumor regression grade (n = 15)
                               No response (%)                               3 (25)
                               Minimal (%)                                   7 (35)
                               Moderate (%)                                  3 (25)
                               Near total (%)                                1 (5)
                               Complete (%)                                  1 (5)
                            Tumor histology
                               Adenocarcinoma (%)                            18 (80)
                               Epidermoid carcinoma (%)                      2 (10)
                            pAJCC stage
                               Stade 0 (%)                                   1 (5)
                               Stade I (%)                                   1 (5)
                               Stade II (%)                                  6 (30)
                               Stade III (%)                                 10 (50)
                               Stade IV (%)                                  2 (10)
                            pT-category
                               pT0 (%)                                       2 (10)
                               pT1 (%)                                       0
                               pT2 (%)                                       2 (10)
                               pT3 (%)                                       13 (65)
                               pT4 (%)                                       3 (15)
                            pN-category
                               pN0 (%)                                       10 (50)
                               pN1 (%)                                       4 (20)
                               pN2 (%)                                       6 (30)
                            pM-category
                               pM0 (%)                                       18 (90)
                               pM1 (%)                                       2 (10)
                            Number of retrieved lymph nodes (mean ± SD)      16.5 ± 7.2
                            Number of metastatic lymph nodes (mean ± SD)     1.9 ± 2.9
                            CRM positive, ≤ 1 mm (%)                         4 (20)
                            CRM depth in mm (mean ± SD)                      2.3 ± 1.9
                            Tumor perforation (%)                            2 (10)
                            Mesorectal grade
                               Incomplete (%)                                1 (5)
                               Nearly complete (%)                           1 (5)
                               Complete (%)                                  18 (90)
                            Distal margin in cm (mean ± SD)                  3.2 ± 1.9
                            Tumor size in cm (mean ± SD)                     4.6 × 3.9 ± 0.3


                                                    [18]
               in our study and Moghadamyeghaneh et al.  showed a significantly decreased conversion rate for RAAPR
               compared to laparoscopic APR (5.7 vs. 13.4%).

               The robotic approach presents technical drawbacks, mostly associated with the loss of haptic feedback.
               Actually, despite the massive help of the immersive 3D overview, vibration, pressure, or shearing forces
                                    [13]
               are not always apparent . A recent analysis of 509,029 patients who underwent elective colectomy in the
               United States from 2009 to 2012 showed that the rate of iatrogenic complications was increased for robotic
                      [20]
               surgery .
               Noteworthy, the results presented here are worse than our previously published results for sphincter-
                               [21]
               saving procedures . The morbidity rate was 60%, with mainly perineal wound disunions and urinary
               complications. The mean length of hospital stay was three weeks, which is longer than in other studies in
               the literature [Table 5]. In this series, no patient was included in any “Enhanced Recovery After Surgery”
               program, and perineal wound complications were associated with longer hospital stay. Indeed, three
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