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Robotic-Assisted Versus Laparoscopic-Assisted Colectomy: Findings on Short-Term Outcomes From A Multi-Institutional

Ching-Wen Huang1,2, Chien-Chih Chen3, Jeng-Fu You4

  • 1Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

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Robotic-assisted colectomy (RAC) is a safe alternative to laparoscopic-assisted colectomy (LAC) for colon cancer, showing similar oncological outcomes but a shorter hospital stay. RAC also demonstrated fewer complications for right hemicolectomy patients.

Keywords:
laparoscopic‐assisted colectomymulti‐institutional studypropensity score‐matchingrobotic‐assisted colectomyshort‐term outcomes

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Area of Science:

  • Surgical Oncology
  • Minimally Invasive Surgery
  • Gastrointestinal Surgery

Background:

  • Laparoscopic-assisted colectomy (LAC) is a standard minimally invasive approach for colon cancer.
  • Robotic-assisted colectomy (RAC) is an emerging alternative with potential benefits.
  • Comparative data on short-term outcomes and complications between RAC and LAC in colon cancer patients are limited, especially from multi-institutional studies in Taiwan.

Purpose of the Study:

  • To compare the short-term outcomes and perioperative complications of robotic-assisted colectomy (RAC) versus laparoscopic-assisted colectomy (LAC) in patients with colon cancer.
  • To evaluate the safety and feasibility of RAC as an alternative to LAC.
  • To identify potential advantages of RAC in specific colectomy subgroups.

Main Methods:

  • Retrospective analysis of 838 patients with colon adenocarcinoma undergoing RAC or LAC at five Taiwanese medical centers (January 2015 - December 2021).
  • Propensity score matching was used to create comparable cohorts for analysis.
  • Data on baseline characteristics, operative details, perioperative outcomes, and complications were extracted from medical records.

Main Results:

  • While RAC had a longer median operative time, especially for left/sigmoid colectomies, conversion rates were similar to LAC.
  • Robotic-assisted colectomy (RAC) was associated with a significantly shorter postoperative length of stay by one day compared to LAC.
  • Overall postoperative complications, 30-day mortality, and local recurrence rates were comparable; however, RAC showed a significantly lower complication rate in the right hemicolectomy subgroup.

Conclusions:

  • Robotic-assisted colectomy (RAC) is a safe and feasible option for colon cancer treatment, offering comparable oncological safety to laparoscopic-assisted colectomy (LAC).
  • RAC may provide advantages, including a reduced length of hospital stay and potentially fewer complications in specific procedures like right hemicolectomy.
  • This multi-institutional propensity score-matched study provides valuable insights into the comparative effectiveness of RAC and LAC in the Taiwanese population.