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Introduction: Compared with laparoscopic surgery (LS), robotic surgery (RS) is considered to have acceptable outcomes in rectal cancer, but few reports have focused on chylous ascites in RS. The aim of this study was to investigate the incidence and etiology of chylous ascites after RS. Methods: This retrospective study included 291 patients with rectal cancer who underwent RS (n = 165) or LS (n = 126) with high ligation of the inferior mesenteric artery (IMA). Propensity score matching (PSM) was performed to compare the two groups. Results: \Dissection around the IMA was achieved using ultrasonic coagulating shears in most LS cases, and monopolar scissors in most RS cases, sometimes using bipolar vessel sealing device or bipolar forceps. The incidence of chylous ascites was 12.2% in RS and 4.1% in LS after PSM (P =.037). When limited to the RS group, multivariate analysis identified absence of lymphatic sealing at the left side of the IMA and shorter operative time as independent risk factors for chylous ascites. Except for duration of drain placement, no outcomes differed significantly with or without chylous ascites. One patient with chylous ascites developed later infection and required antibiotic treatment. Conclusion: The incidence of chylous ascites is significantly higher in RS than in LS, and RS with incomplete lymphatic sealing around the IMA is a risk factor for chylous ascites in rectal cancer. Although outcomes for patients with chylous ascites were acceptable, adequate lymphatic sealing during dissection around the IMA is crucial to prevent chylous ascites in RS. [ABSTRACT FROM AUTHOR]

Introduction: Robot‐assisted laparoscopic surgery has been performed in various fields, especially in the pelvic cavity. However, little is known about the utility of robot‐assisted laparoscopic rectal cancer surgery associated with robot‐assisted radical prostatectomy (RARP). We herein report the clinical impact of robot‐assisted laparoscopic rectal cancer surgery associated with RARP. Methods: We experienced five cases of robot‐assisted laparoscopic rectal cancer surgery associated with RARP. One involved robot‐assisted laparoscopic abdominoperineal resection with en bloc prostatectomy for T4b rectal cancer, and one involved robot‐assisted laparoscopic intersphincteric resection combined with RARP for synchronous rectal and prostate cancer. The remaining three involved robot‐assisted laparoscopic low anterior resection (RaLAR) after RARP. For robot‐assisted laparoscopic rectal cancer surgery, the da Vinci Xi surgical system was used. Results: We could perform planned robotic rectal cancer surgery in all cases. The median operation time was 529 min (373–793 min), and the median blood loss was 307 ml (32–1191 ml). No patients required any transfusion in the intra‐operative or immediate peri‐operative period. The circumferential resection margin was negative in all cases. There were no complications of grade ≥III according to the Clavien‐Dindo classification and no conversions to conventional laparoscopic or open surgery. Conclusion: Robot‐assisted laparoscopic surgery associated with RARP is feasible in patients with rectal cancer. The long‐term surgical outcomes remain to be further evaluated. [ABSTRACT FROM AUTHOR]

Background: T4 is one of the high-risk factors, but the efficacy of adjuvant chemotherapy for T4-Stage Ⅱ colon cancer are unclear., Method: We retrospectively reviewed 211 patients with primary pStage Ⅱ colon cancer who underwent radical resection between 2004 and 2015., Results: The 5-year overall survival rate(OS)of Stage ⅡA/ⅡB/ⅡC were 90.2/83.4/ 59.2%, and the 5-year recurrence-free survival rate(RFS)were 87.3/73.3/42.8%. Multivariate analysis of OS as a high-risk factor of T4 revealed male, ly2/3, no adjuvant chemotherapy, and in RFS, male, ly2/3. However, compared the cases with or without adjuvant chemotherapy, 5-year OS was no difference. There were no cases used oxaliplatin-based adjuvant chemotherapy., Conclusion: An adjuvant chemotherapy without oxaliplatin were not enough to improve the prognoses of T4-Stage Ⅱcolon cancer, so the oxaliplatin based regimen might be recommended.