講演情報
[JKS1-3]The Benefits of Upfront Surgery for Locally Advanced Rectal Cancer
Akio Shiomi (Division of Colon and Rectal Surgery, Shizuoka Cancer Center)

Robot-assisted surgery is a promising modality with high degrees of freedom and tremor suppression capabilities, making it a potentially more precise approach than conventional laparoscopic surgery.
In Japan, the number of robot-assisted procedures for rectal cancer has rapidly increased since national insurance coverage was introduced in 2018. Studies using large-scale domestic databases have demonstrated a reduction in the conversion rate to open surgery compared to laparoscopic surgery. Additionally, randomized controlled trials from overseas have shown that robot-assisted surgery facilitates more reliable achievement of a negative circumferential resection margin (CRM).
In 2022, insurance coverage was extended to colon cancer. Evidence from domestic multicenter prospective studies has confirmed the usefulness of robot-assisted surgery, particularly in terms of reducing conversion rates and postoperative complications.
Since 2023, new surgical robotic systems have been launched by various manufacturers, increasing the range of available options.
Reflecting these developments, the 2024 edition of the Japanese Guidelines for the Treatment of Colorectal Cancer strongly recommends robot-assisted surgery as a treatment option for rectal cancer, and weakly recommends it for colon cancer.
At our department, we have performed over 1,800 robot-assisted surgeries for colorectal cancer since 2011. In this presentation, we will highlight our outcomes-particularly under the principle of upfront surgery - and discuss the current status and future perspectives of robot-assisted surgery.
In Japan, the number of robot-assisted procedures for rectal cancer has rapidly increased since national insurance coverage was introduced in 2018. Studies using large-scale domestic databases have demonstrated a reduction in the conversion rate to open surgery compared to laparoscopic surgery. Additionally, randomized controlled trials from overseas have shown that robot-assisted surgery facilitates more reliable achievement of a negative circumferential resection margin (CRM).
In 2022, insurance coverage was extended to colon cancer. Evidence from domestic multicenter prospective studies has confirmed the usefulness of robot-assisted surgery, particularly in terms of reducing conversion rates and postoperative complications.
Since 2023, new surgical robotic systems have been launched by various manufacturers, increasing the range of available options.
Reflecting these developments, the 2024 edition of the Japanese Guidelines for the Treatment of Colorectal Cancer strongly recommends robot-assisted surgery as a treatment option for rectal cancer, and weakly recommends it for colon cancer.
At our department, we have performed over 1,800 robot-assisted surgeries for colorectal cancer since 2011. In this presentation, we will highlight our outcomes-particularly under the principle of upfront surgery - and discuss the current status and future perspectives of robot-assisted surgery.