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Long-term oncologic after robotic versus laparoscopic right colectomy: a prospective randomized study.
Jun Seok Park1,2, Hyun Kang3, Soo Yeun Park1
1Colorectal Cancer Center, School of Medicine, Kyungpook National University Medical Center, Kyungpook National University, Daegu, South Korea.
Surgical Endoscopy
|November 21, 2018
Summary
Robot-assisted right colectomy (RAC) shows similar long-term survival to conventional laparoscopy-assisted right surgery (LAC) for colon cancer. However, RAC involves longer operation times and higher costs without clear clinical benefits.
Area of Science:
- Colorectal surgery
- Surgical oncology
- Minimally invasive surgery
Background:
- Robotic techniques are increasingly used for colorectal malignancies.
- The oncologic safety of robotic surgery requires further definition.
Purpose of the Study:
- To compare the long-term outcomes of robot-assisted right colectomy (RAC) versus conventional laparoscopy-assisted right surgery (LAC).
- To evaluate the oncologic safety and survival rates of RAC compared to LAC in treating right-sided colon cancer.
Main Methods:
- Randomized study of 71 patients with right-sided colon cancer from September 2009 to July 2011.
- Comparison of robot-assisted right colectomy (RAC) and laparoscopy-assisted right surgery (LAC).
- Intention-to-treat analysis of hospital stay, survival, and recurrence rates.
Main Results:
- RAC had longer operation times (195 min vs. 129 min) and higher costs ($12,235 vs. $10,319) compared to LAC.
- No significant difference in 5-year disease-free rates (77.4% RAC vs. 83.6% LAC) or overall survival rates (91.1% RAC vs. 91.0% LAC).
- Multivariate analysis indicated RAC was not a predictor of recurrence.
Conclusions:
- Robot-assisted right colectomy (RAC) demonstrates comparable long-term survival to laparoscopy-assisted right surgery (LAC).
- No significant clinical benefits were observed with RAC that would justify increased expenditures.
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