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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