Chirurgia (2015) 110: 137-143 No. 2, March - April Copyright© Celsius Rezumat Excizia totalã de mezorect efectuatã robotic pentru cancerul rectal Introducere: Cancerul de rect este o problemã importantã de sãnãtate publicã, prin numãrul tot mai mare de cazuri nou apãrute æi prin aspectele de calitate a vieåii pe care le ridicã tratamentul chirurgical al acestor pacienåi. Material æi metodã: Au fost analizaåi retrospectiv pacienåii diagnosticaåi cu cancer rectal æi operaåi folosindu-se chirurgia roboticã, între anii 2008 æi 2012, în Institutul Clinic Fundeni. Rezultate: Au fost operaåi robotic un numãr de 117 pacienåi cu cancer rectal, dintre care la 79(67,52%) s-a practicat excizia totalã de mezorect (TME). Operaåia cea mai frecvent efectuatã a fost rezecåia anterioarã joasã, urmatã de amputaåia de rect. Fistula de anastomozã am observat-o la 9 (11,39%) dintre pacienåi. Recidiva localã a fost întâlnitã la 2 (2,53%) dintre cazurile operate robotic. Concluzii: 1. Excizia totalã de mezorect asistatã robotic este fezabilã, sigurã æi poate fi efectuatã cu un numãr scãzut de complicaåii æi o ratã micã de recidivã localã; 2. Principalele avantaje sunt siguranåa oncologicã şi calitatea vieåii; 3. Conversia la chirurgia deschisã este rar întâlnitã; 4. Existenåa ileostomei de protecåie permite evitarea reintervenåiei în caz de apariåie a fistulei de anastomozã la pacienåii cu rezecåie anterioarã joasã. 5. Chirurgia roboticã poate deveni standard de aur în tratamentul chirurgical al cancerului de rect. Cuvinte cheie: abord robotic, excizie totala de mezorect, rezultate oncologice, morbiditate Abstract Background: Rectal cancer is an important health problem, due to the increasing number of new cases and the quality of life issues brought forth by surgical treatment in these patients. Aim: The aim of the study was to analyse the results of robotic surgery in the treatment of lower and middle rectal cancer, locations in which TME is performed. Material and Method: Patients diagnosed with and operated on for rectal cancer by the means of robotic surgery between 2008- 2012 at the Fundeni Clinical Institute were retrospectively analysed. Results: A number of 117 patients with rectal cancer were operated on by robotic surgery, of which 79 (67.52%) were submitted to total mesorectal excision (TME). The most fre- quently performed surgery was low anterior resection, followed by rectal amputation through abdominoperineal approach. Anastomosis fistula was observed in 9 (11.39%) patients. Local recurrence was encountered in 2 (2.53%) of the robotically performed surgeries. Conclusions: 1. Robotically assisted total mesorectal excision is feasible, safe and can be performed with a small number of complications and a low local recurrence rate; 2. The main advantages are oncological safety and quality of life; 3. Conversion to open surgery is rarely encountered; 4. Protection loop ileostomy existence allows avoiding reintervention in case Robotically Performed Total Mesorectal Excision for Rectal Cancer L. Alecu 1 , O. Stãnciulea 2 , D. Poesina 3 , V. Tomulescu 2 , C. Vasilescu 2 , I. Popescu 2 1 Clinical General Surgery Department, Prof. Dr. Agrippa Ionescu Clinical Emergency Hospital, Bucharest, Romania 2 Dan Setlacec Centre for General Surgery and Liver Transplant, Fundeni Clinical Institute, Bucharest, Romania 3 Carol Davila University of Medicine and Pharmacy, Bucharest, Romania Corresponding author: Dr. Lucian Alecu Clinical General Surgery Department “Prof. Dr. Agrippa Ionescu” Clinical Emergency Hospital, Bucharest No. 7 Arh. Ion Mincu street, Sector 1, Bucharest, Romania E-mail: lucianalecu@yahoo.com