Robotic versus laparoscopic right hemicolectomy: a retrospective cohort study of the Binational Colorectal Cancer Database

Clarke, EM; Rahme, J; Larach, T; Rajkomar, A; Jain, A; Hiscock, R; Warrier, S; Smart, P

Author(s): Clarke, EM; Rahme, J; Larach, T; Rajkomar, A; Jain, A; Hiscock, R; Warrier, S; Smart, P;
Details: Publication Year 2022-08,Volume 16,Issue #4,Page 927-933
Journal Title: Journal of Robotic Surgery
Publication Type: Research article
Abstract: Robotic right hemicolectomy (RRC) may have technical advantages over the conventional laparoscopic right colectomy (LRC) due to higher degrees of rotation, articulation, and tri-dimensional imaging. There is growing literature describing advantages of RRC compared to LRC; however, there is a lack of evidence about safety, oncologic quality of surgery and cost. This study aimed to analyse complication rates, length of stay and nodal harvest in patients undergoing minimally invasive right hemicolectomy for colon cancer from a prospective Australasian colorectal cancer database. This was a retrospective cohort study using nearest neighbour matching. The Binational Colorectal Cancer Audit (BCCA) provided the data for analysis. The primary outcome was length of stay. Secondary outcomes were harvested lymph node count, anastomotic leak, postoperative haemorrhage, abdominal abscess, postoperative ileus, wound infections and non-surgical complications. 4977 patients who underwent robotic (n = 146) or laparoscopic (n = 4831) right hemicolectomy for right-sided colon cancer were included. For RRC, LOS was shorter (5 vs 6.9 days, p = 0.01) and nodal harvest was higher (22 vs 19, p = 0.04). For RRC, surgical complications (5.9% vs 14.2%, p < 0.004) and non-surgical complications (4.6% vs 11.7%, p = 0.007) were lower though there was no difference in return to theatre or inpatient death. Robotic right hemicolectomy is associated shorter LOS and marginally higher lymph node count, though this may reflect anastomotic technique rather than surgical platform. Longer term studies are required to establish differences in overall survival, incisional hernia rates and cost effectiveness.
Keywords: Anastomosis, Surgical/methods; Colectomy/adverse effects/methods; *Colonic Neoplasms/pathology/surgery; Humans; *Laparoscopy/adverse effects/methods; Length of Stay; Operative Time; Prospective Studies; Retrospective Studies; *Robotic Surgical Procedures/methods; Treatment Outcome; Colectomy; Colorectal neoplasms; Intracorporeal anastomosis; Robotic surgical procedures
Department(s): Surgical Oncology
PubMed ID: 34709537
Publisher's Version: https://doi.org/10.1007/s11701-021-01319-z
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-10-16 06:19:40

Last Modified: 2024-10-16 06:21:19