Gender‐Specific Cancer‐Related Survival Analysis of Robotic Versus Laparoscopic Low Anterior Resection for Rectal Adenocarcinoma: A Multicenter Study

ABSTRACT Aim This study compared short‐ and long‐term outcomes of robotic and laparoscopic low anterior resection (LAR) for rectal adenocarcinoma using sex‐stratified analyses. Methods Patients who underwent elective robotic or laparoscopic LAR for rectal cancer were included. Prospectively maintained 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/m 2 ). In a matched cohort of males ( 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 in females was associated with fewer harvested lymph nodes ( p = 0.01). Five‐year disease‐specific survival rates did not significantly 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.