Comparison of surgical outcomes between robot-assisted and laparoscopic right colectomy for colon cancer: a...

To assess the feasibility of robot-assisted right colectomy (RRC) for right-sided colon cancer by comparing its short-term surgical outcomes with those of laparoscopic right colectomy (LRC). We retrospectively reviewed consecutive patients undergoing elective right colectomy for stage I-III colon adenocarcinoma (LRC, n = 75; RRC, n = 50). The primary endpoint was overall 30-day postoperative morbidity; overall survival (OS), relapse-free survival (RFS), and other perioperative measures were secondary. A pre-specified exploratory analysis measured anastomotic time on intraoperative video in patients receiving an intracorporeal anastomosis (IA; robotic, n = 10; laparoscopic, n = 3). Median follow-up was 22.6 months. Baseline characteristics were balanced. Blood loss was lower with RRC (median 5 vs. 10 mL, p = 0.005), a clinically irrelevant difference, while operative time was longer (290 vs. 251 min, p = 0.05); setup and docking took a median of 24.5 min and console time 211.5 min. IA was used far more often in RRC (88.0% vs. 6.7%, p < 0.001). Morbidity, Clavien-Dindo grade ≥ III events, leakage, and hospital stay were similar. Robotic IA (n = 10) was faster than laparoscopic IA (n = 3; 33.4 vs. 40.7 min, p = 0.049), though underpowered. Neither OS nor RFS differed (log-rank p = 0.12 and 0.13). RRC was as safe as LRC perioperatively, with no difference in early OS or RFS, although the study was not powered for equivalence. The shorter robotic anastomotic time, observed despite greater institutional experience with laparoscopic IA, is hypothesis-generating and merits confirmation in adequately powered studies.