{"id":28587,"date":"2025-08-09T04:54:00","date_gmt":"2025-08-08T20:54:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=28587"},"modified":"2025-08-09T06:12:55","modified_gmt":"2025-08-08T22:12:55","slug":"jama%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e4%b8%ad%e4%b8%8b%e6%ae%b5%e7%9b%b4%e8%82%a0%e7%99%8c%e7%9a%84%e6%9c%ba%e5%99%a8%e4%ba%ba%e4%b8%8e%e8%85%b9%e8%85%94%e9%95%9c%e6%89%8b%e6%9c%af","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=28587","title":{"rendered":"[JAMA\u53d1\u8868\u8bba\u6587]\uff1a\u4e2d\u4e0b\u6bb5\u76f4\u80a0\u764c\u7684\u673a\u5668\u4eba\u4e0e\u8179\u8154\u955c\u624b\u672f"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

June 2, 2025<\/p>\n\n\n\n

Robotic vs Laparoscopic Surgery for Middle and Low Rectal Cancer: The REAL Randomized Clinical Trial<\/h1>\n\n\n\n

Qingyang Feng, Weitang Yuan, Taiyuan Li, et al<\/h3>\n\n\n\n

JAMA. <\/em>Published online June 2, 2025. doi:10.1001\/jama.2025.8123<\/h3>\n\n\n\n

Key Points<\/p>\n\n\n\n

Question<\/strong>  Can the use of robotic surgery reduce the locoregional recurrence rate of middle and low rectal cancer compared with the use of laparoscopic surgery?<\/p>\n\n\n\n

Findings<\/strong>  In this randomized clinical trial including patients with middle or low rectal cancer, the 3-year locoregional recurrence rate was 1.6% for robotic surgery vs 4.0% for laparoscopic surgery.<\/p>\n\n\n\n

Meaning<\/strong>  The use of robotic surgery demonstrated superior oncological and functional outcomes compared with the use of laparoscopic surgery in patients with middle or low rectal cancer.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  Robotic surgery for rectal cancer is widely used, but data on long-term oncological outcomes are still lacking.<\/p>\n\n\n\n

Objective<\/strong>  To compare the 3-year locoregional recurrence rates of middle and low rectal cancer in patients who underwent robotic surgery vs conventional laparoscopic surgery.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  In this multicenter, superiority, randomized clinical trial, patients with middle or low rectal adenocarcinoma (cT1-T3, N0-N1, or ycT1-T3 Nx) and no distant metastasis were enrolled at 11 centers across 8 provinces in China from July 2016 to December 2020. Among the 1742 consecutive patients assessed for eligibility, 1240 were eligible and randomized. Follow-up continued until December 31, 2023.<\/p>\n\n\n\n

Interventions<\/strong>  Patients were randomized 1:1 to undergo robotic or conventional laparoscopic rectal cancer resection.<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  The primary outcome was the 3-year locoregional recurrence rate. The primary analysis was performed as randomized, but excluded patients deemed ineligible after randomization. The secondary outcomes included disease-free survival; overall survival; and urinary, sexual, and defecation function.<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0Of the 1240 patients enrolled, 1171 were included in the primary analysis (586 in the robotic surgery group; mean age, 59.1 [SD, 11.0] years; and 356 were men [60.8%] vs 585 in the laparoscopic surgery group; mean age, 60.7 [SD, 9.8] years; and 354 were men [60.5%]). The median follow-up time was 43.0 months (IQR, 36.7-60.0 months). The 3-year locoregional recurrence rate was 1.6% (95% CI, 0.6%-2.6%) in the robotic group vs 4.0% (95% CI, 2.4%-5.6%) in the laparoscopic group (hazard ratio [HR], 0.45 [95% CI, 0.22-0.92], log-rank\u00a0P<\/em>\u2009=\u2009.03; adjusted HR, 0.39 [95% CI, 0.19-0.80]). The 3-year disease-free survival rate was higher in the robotic group (87.2%) vs the laparoscopic group (83.4%) (HR, 0.74 [95% CI, 0.56-0.98], log-rank\u00a0P<\/em>\u2009=\u2009.04; adjusted HR, 0.67 [95% CI, 0.50-0.89]). No significant between-group difference was observed in 3-year overall survival (94.7% in the robotic group vs 93.0% in the laparoscopic group). Patients in the robotic group also had better urinary function, male and female sexual function, and defecation function at 3 and 6 months after surgery and better urinary function and male sexual function at 12 months after surgery.<\/p>\n\n\n\n

\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n

Conclusions and Relevance<\/strong>  Compared with conventional laparoscopic surgery, robotic surgery significantly improved long-term oncological outcomes in patients with middle or low rectal cancer. With additional real-world clinical data and modern, improved training programs for surgeons, robotic surgery could be the preferred choice for patients with middle or low rectal cancer.<\/p>\n\n\n\n

Trial Registration<\/strong>  ClinicalTrials.gov Identifier: NCT02817126<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  June 2, 2025 Rob […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/28587"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=28587"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/28587\/revisions"}],"predecessor-version":[{"id":28889,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/28587\/revisions\/28889"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=28587"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=28587"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=28587"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}