Short-Term Outcomes of Robot-Assisted Versus Laparoscopic Colectomy for Colon Cancer: A Propensity Score-Matched...

Clinical benefits of robot-assisted colectomy over laparoscopic colectomy for colon cancer remain uncertain, and real-world data are limited. We evaluated the short-term outcomes of robot-assisted colectomy versus laparoscopic colectomy in patients with colon cancer.

This single-center, retrospective cohort study evaluated patients who underwent minimally invasive colectomies for colon cancer at Osaka General Medical Center from January 2014 to November 2024. Short-term outcomes were compared after 1:1 propensity score matching to minimize confounding by indication.

In total, 480 patients underwent laparoscopic colectomies and 282 underwent robot-assisted colectomies, with 218 matched pairs. Baseline characteristics were well-balanced. Surgical procedure distribution was similar between the groups (P = 0.897). Mean operative times were significantly longer (212 vs. 200 min, P = 0.040), mean intraoperative blood loss was significantly lower (22.8 vs. 37.5 mL, P < 0.001), rates of conversion to open surgery were significantly lower (0.0% vs. 2.3%, P = 0.026), and mean hospital stays were significantly shorter (7.0 vs. 11.3 d, P < 0.001) in the robot-assisted colectomy group. The number of lymph node dissections (P = 0.27) and local R0 resection rates (P = 0.34) were comparable. Overall complication rates were significantly lower in the robot-assisted colectomies (11.0% vs. 17.9%, P = 0.007), whereas clinically meaningful complication rates (Clavien-Dindo grades ≥ II) were comparable (P = 0.150).

These findings provide real-world data supporting the feasibility of robot-assisted colectomy for colon cancer treatment. Further research should evaluate the long-term oncologic outcomes and cost-effectiveness.