Gender-specific cancer-related survival analysis of robotic versus laparoscopic low anterior resection for rectal adenocarcinoma: A multicenter study

Aim: This study compared short‐ and long‐term outcomes of robotic and laparoscopic low anterior resection (LAR) for rectaladenocarcinoma using sex‐stratified analyses.Methods: Patients who underwent elective robotic or laparoscopic LAR for rectal cancer were included. Prospectively main-tained database of outcomes was analysed retrospectively. To minimise selection bias, groups were matched.Results: Of 409 identified patients, 380 met the eligibility criteria (mean age: 61 years, BMI: 26.2 kg/m2). In a matched cohort ofmales (n = 172) and females (n = 114), robotic surgery was associated with significantly shorter hospital stay (p < 0.01).Harvested lymph nodes, margins, morbidity and local recurrence were comparable in males (p > 0.05). Robotic surgery infemales was associated with fewer harvested lymph nodes (p = 0.01). Five‐year disease‐specific survival rates did not signifi-cantly differ between approaches in either gender.Conclusions: Robotics and laparoscopic LAR achieved similar oncologic outcomes. The findings should be interpreted as sex‐stratified comparisons rather than evidence of differential effect of surgical approach according to sex.