Robotic versus laparoscopic anterior resection: comparative short-term outcomes in a propensity score matched cohort

The use of robotic assistance in colorectal surgery has mainly shown benefit in low rectal resections. The comparisons between robotic and laparoscopic high anterior resections have largely reported similar clinical outcomes at the expense of higher cost and longer operative time in the former. Most of these involve unmatched retrospective studies based on earlier robotic systems. The current study aims to provide contemporary data from a center with an established robotic surgery practice. Patients who underwent elective robotic anterior resections between January 2021 and December 2023 were propensity-score matched with a laparoscopic group. Perioperative management was in accordance with an Enhanced Recovery protocol. Outcomes and histopathological data were compared. One hundred and thirty patients were available for analysis after matching. The use of robotic assistance was associated with significantly less intra-operative blood loss, shorter operative duration, faster recovery of gastrointestinal function, earlier discharge, and lower complication rate. There was no significant difference in tumor characteristics or short-term oncological outcomes. Robotic assistance provides benefits that are clinically significant to both the patient and the healthcare system.