Robotic versus laparoscopic surgery for colorectal cancer: a case-control study

Abstract

Background Robotic resections represent a novel approach to treatment of colorectal cancer. The aim of our study was to critically assess the implementation of robotic colorectal surgical program at our institution and to compare it to the established laparoscopically assisted surgery. Patients and methods A retrospective case-control study was designed to compare outcomes of consecutively operated patients who underwent elective laparoscopic or robotic colorectal resections at a tertiary academic centre from 2019 to 2020. The associations between patient characteristics, type of operation, operation duration, conversions, duration of hospitalization, complications and number of harvested lymph nodes were assessed by using univariate logistic regression analysis. Results A total of 83 operations met inclusion criteria, 46 robotic and 37 laparoscopic resections, respectively. The groups were comparable regarding the patient and operative characteristics. The operative time was longer in the robotic group (p < 0.001), with fewer conversions to open surgery (p = 0.004), with less patients in need of transfusions (p = 0.004) and lower reoperation rate (p = 0.026). There was no significant difference between the length of stay (p = 0.17), the number of harvested lymph nodes (p = 0.24) and the overall complications (p = 0.58). Conclusions The short-term results of robotic colorectal resections were comparable to the laparoscopically assisted operations with fewer conversions to open surgery, fewer blood transfusions and lower reoperation rate in the robotic group.

Is Robotic Assisted Colorectal Cancer Surgery Equivalent Compared to Laparoscopic Procedures during the Introduction of a Robotic Program? A Propensity-Score Matched Analysis

“…The goal of this study was to evaluate the feasibility and safety of the robotic platform regarding perioperative morbidity and histopathological findings compared to conventional laparoscopic techniques. In accordance with previous studies [9,18,19], we observed a longer operative time in the robotic-assisted group, which could be explained by the surgeons' lack of experience using the system at the beginning of the robotic program. A detailed analysis of the duration of the operation confirms this trend: Figure 1 shows that operative time decreased with the number of procedures.…”

“…However, trocar placement and docking of the robotic-assisted system also require time in the case of a completed learning curve [18]. The most relevant outcome of this study was the significantly lower conversion rate compared to conventional laparoscopic resection (LR Group: 16 (19.51%) vs. RR Group: 5 (5.38%), p = 0.004), which is consistent with the results of the previous published literature [9,18,22]. Several laparoscopic studies, including randomized trials (COST [23], CLASSIC [24]), demonstrated that conversions are associated with a worse oncological outcome and higher postoperative complication rates [19,25].…”

“…Moreover, first studies reported similar oncological long-term data for both techniques [7,8]. The evolution of robotic surgery is well-illustrated by bibliometric data, as more and more studies are published in the literature [9]. While clinical outcomes generally seem to be equivalent to those achieved via laparoscopy, robotic platforms require significantly more initial costs with longer operation room times [10].…”

Implementing a pediatric robotic surgery program: future perspectives

“…It is considered the procedure of choice in surgeries such as radical prostatectomy or colectomy and coloanal anastomosis (8,9) .…”

Implementación de un programa de cirugía robótica pediátrica. Perspectivas futuras

“…Se considera de elección en procedimientos como la prostatectomía radical o la colectomía y el descenso coloanal (8,9) .…”