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Robotic, laparoscopic, and open colectomy: a case-matched comparison from the ACS-NSQIP
Cigdem Benlice1, Erman Aytac1, Meagan Costedio1
1Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Ohio, USA.
Background:
This study aimed to compare perioperative outcomes of patients undergoing robotic, laparoscopic, and open colectomy using a procedure-targeted database.
Methods:
Retrospective review of patients undergoing elective colectomy in 2013 was conducted using the procedure-targeted database of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). Robotic, laparoscopic, and open groups were matched (1:1:1) based on age, gender, body mass index, surgical procedure, diagnosis and ASA classification. Demographics, comorbidities, and short-term (30 day) outcomes were compared.
Results:
Out of 12 790 patients, 387 fulfilled criteria per group after matching. Univariate comparison showed operating time was longer (P < 0.001) and hospital stay was shorter (P < 0.001) in the robotic group. Morbidity (P < 0.001), superficial SSI (P < 0.001), bleeding requiring transfusion (P < 0.001), ventilator dependency (P = 0.003), and ileus (P < 0.001) rates were lower in the robotic group. After adjusting for confounders, outcomes were comparable between the groups except hospital stay which was shorter in the robotic group (P < 0.001).
Conclusions:
ACS-NSQIP data demonstrated several short-term advantages of robotic surgery compared with laparoscopic and open surgery.
